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A controlled study of the reliability of pure tone audiometry for the detection of gentamicin auditory toxicity

Published online by Cambridge University Press:  29 June 2007

P. G. Davey*
Affiliation:
Birmingham
F. J. Jabeen
Affiliation:
Birmingham
E. S. Harpur
Affiliation:
Birmingham
P. M. Shenoi
Affiliation:
Birmingham
A. M. Geddes
Affiliation:
Birmingham
*
Wards 5/6, Ninewells Hospital, Ninewells, Dundee DD1 9SY.

Abstract

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 health volunteers, once in an anechoic chamber and twice in a ward. It was concluded that changes in threshold <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 patient's 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.

Type
Research Article
Copyright
Copyright © JLO (1984) Limited 1983

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