Study of auditory function in children with chronic lung diseases Hanan M. Ibrahim a , Terez B. Kamel a, *, Nithreen M.S. Abdel-Salam b , S.R. Abu-Ata a a Pediatrics Department, Ain Shams University, Cairo, Egypt b Audiology Unit, Otolaryngology Department, Ain Shams University, Cairo, Egypt 1. Introduction Pediatric chronic lung diseases may include any of the following; bronchiectasis, interstitial pulmonary fibrosis, bronch- opulmonary dysplasia, bronchiolitis obliterans, sequestrated lung disease or cystic fibrosis. They can be primary or secondary. They can be congenital or acquired [1]. Hypoxia is a consequence of every pulmonary disease entity. Hypoxia gradually reduces cochlear function [2]. It is well recognized that the use of aminoglycosides antibiotics carries a risk of auditory and vestibular toxicity. Its typical pattern is high frequency hearing affection due to progressive loss of function from the outer hair cells to the inner hair cell [3]. Therapy of chronic lung diseases involves the prophylactic use of antibiotic as 300 mg of tobramycin by aerosol twice daily to reduce sputum pseudomonas density or 40 mg of aerosolized gentamycin twice daily for 3 days/week to reduce the level of neutrophilic enzymes in sputum [4,5]. Otoacoustic emissions (OAEs) reflect non-linear distortion and linear reflection mechanisms in the cochlea that can be recorded in the ear canal and are considered a product of an active process from the outer hair cells to the basilar membrane [6,7]. Transient evoked otoacoustic emissions (TEOAEs) are frequency dispersive responses following a brief acoustic stimulus such as click or tone burst [8]. Otoacoustic emission (OAE) testing can identify the cochlear component of a hearing disorder and monitor objectively minute changes in cochlear status undetectable by other audiological methods [6–8]. 2. Subjects and methods During the period from March 2008 to November 2008, this cross sectional study was carried out at the Pediatric Chest Clinic, Children’s hospital; audiological examinations were carried out in Audiology unit, Demerdash hospital; Ain Shams University, Cairo, Egypt. It included 30 children with chronic lung diseases. Their age ranged between 3.2 and 17 years, eighteen (60%) were males and twelve (40%) were females. Twenty healthy children sex and age matched with patient’ group were included as control. A verbal uniform consent was obtained from all the patients’ parents. The Pediatric Department Board ethically approved the study. Patients had history of recurrent otitis media or family history of deafness, those showed abnormal tympanometry, asthmatic patients and tuberculous patients were excluded from the study. Otoscopic examination, pure tone and speech audiometry using Madeson Electronic audiometer, model Orbiter 922 in a sound International Journal of Pediatric Otorhinolaryngology 75 (2011) 39–42 ARTICLE INFO Article history: Received 7 July 2010 Received in revised form 21 September 2010 Accepted 4 October 2010 Available online 29 October 2010 Keywords: Chronic lung diseases Egyptian children Inhaled aminoglycosides Cochlear dysfunction Otoacoustic emissions ABSTRACT Objective: Chronic hypoxia has an evident effect on cochlear function and hearing sensitivity. Otoacoustic emissions’ testing is efficient in detecting subtle cochlear dysfunction. This cross sectional study was designed to assess the cochlear function in children with chronic lung diseases who were exposed to prolonged hypoxia and prolonged use of ototoxic drugs (as aminoglycosides) using basic audiological evaluation and transient evoked otoacoustic emissions testing. Methods: The study was carried out on 30 Egyptian children with chronic lung disease recruited from the Pediatric Chest Clinic, Children’s hospital, Ain Shams University. Twenty normal children were included as control. Results: Six patients (20%) showed abnormal otoacoustic emissions. A significant effect of hypoxia on otoacoustic emissions findings was found (P < 0.05). However, there was no significant effect of inhaled aminoglycosides on auditory functions whether pure tone audiometry, speech audiometry and transient evoked otoacoustic emissions testing. Conclusions: Children with chronic lung diseases are liable to cochlear dysfunction due to prolonged hypoxia. Inhaled aminoglycosides in chronic lung diseases is relatively safe on auditory functions. ß 2010 Elsevier Ireland Ltd. All rights reserved. * Corresponding author. Tel.: +20 124035744. E-mail address: terez2003@hotmail.com (T.B. Kamel). Contents lists available at ScienceDirect International Journal of Pediatric Otorhinolaryngology journal homepage: www.elsevier.com/locate/ijporl 0165-5876/$ – see front matter ß 2010 Elsevier Ireland Ltd. All rights reserved. doi:10.1016/j.ijporl.2010.10.002