Pure Tone Audiometry - Cancer Science

What is Pure Tone Audiometry?

Pure tone audiometry is a hearing test used to identify hearing thresholds of an individual, determining the softest sounds a person can hear at various frequencies. This test is vital for diagnosing hearing loss and is conducted using an audiometer. The results are plotted on an audiogram, which helps in understanding the degree and type of hearing loss.

Why is Pure Tone Audiometry Relevant in Cancer Care?

Cancer patients, particularly those undergoing chemotherapy and radiation therapy, are at risk of ototoxicity, a condition where the ear's structures, especially the cochlea, are damaged by therapeutic agents. Monitoring hearing through pure tone audiometry is crucial for early detection and management of hearing loss, ensuring a better quality of life for the patient.

Which Cancer Treatments Affect Hearing?

Platinum-based chemotherapy drugs, such as cisplatin and carboplatin, are known to cause significant ototoxic effects. Other agents like aminoglycosides (used for infections) and high-dose radiation to the head and neck region can also impact hearing. Regular audiometric evaluations can help in timely interventions.

How is Pure Tone Audiometry Conducted?

During a pure tone audiometry test, the patient wears headphones and listens to a series of tones at different frequencies and volumes. The patient signals when they can hear a tone, and the audiologist records the threshold levels. This process is repeated for each ear and across a range of frequencies, typically from 250 Hz to 8000 Hz.

What are the Pre-test Considerations for Cancer Patients?

Before conducting pure tone audiometry, it is important to consider the patient's overall health status, including the presence of any ear infections or wax buildup which can affect the results. Additionally, informing the audiologist about the specific treatments the patient is undergoing can provide context for interpreting the audiogram.

How Often Should Cancer Patients Undergo Pure Tone Audiometry?

The frequency of audiometric testing varies based on the treatment regimen. For patients on ototoxic drugs, baseline audiometry should be performed before starting treatment, with follow-up tests during and after treatment. This approach helps in monitoring any changes in hearing thresholds and in making necessary adjustments to the treatment plan.

What are the Management Options for Treatment-Induced Hearing Loss?

Management of treatment-induced hearing loss includes dose adjustments or switching to less ototoxic drugs. In some cases, hearing aids or cochlear implants may be recommended. Early intervention through regular audiometry can significantly improve outcomes and quality of life.

Are There Any Preventive Measures?

Preventive measures include using the lowest effective doses of ototoxic drugs, ensuring adequate hydration to minimize drug concentration, and possibly using otoprotective agents. Close monitoring and early detection through pure tone audiometry remain the cornerstone of prevention.

Conclusion

Pure tone audiometry is an essential tool in the comprehensive care of cancer patients, particularly those at risk of ototoxicity from their treatments. By regularly monitoring hearing thresholds, healthcare providers can detect early signs of hearing loss, enabling timely interventions that can preserve the patient's hearing and overall quality of life.