A controlled study of the reliability of pure tone audiometry for the detection of gentamicin auditory toxicity.
Hearing changes in patients treated with gentamicin have been prospectively investigated. A group of patients who had a similar spectrum of clinical conditions but did not receive gentamicin have been studied as a control group. The audiometric technique was first validated by recording audiograms from healthy volunteers, once in an anechoic chamber and twice in a ward. It was concluded that changes in threshold less than 20 db. should not be regarded as significant when measured in a ward. In the gentamicin-treated group an initial audiogram was not a reliable measure of the patients' normal hearing because of the influence of their clinical condition. Twenty-one of the control patients were elective admissions to hospital and had their hearing first tested when they were clinically well. There was a 24 per cent incidence of unexplained hearing abnormalities--similar to the incidence of hearing loss in the gentamicin-treated group at follow-up. It was concluded that aminoglycoside auditory toxicity should not be assessed retrospectively. The incidence of hearing changes in the control and gentamicin-treated groups were similar. Possible causes of hearing loss in surgical patients are discussed and recommendations are made for the conduct of future studies of drug-induced auditory toxicity.[1]References
- A controlled study of the reliability of pure tone audiometry for the detection of gentamicin auditory toxicity. Davey, P.G., Jabeen, F.J., Harpur, E.S., Shenoi, P.M., Geddes, A.M. The Journal of laryngology and otology. (1983) [Pubmed]
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