Functional Impacts of Aminoglycoside Treatment on Speech Perception and Extended High-Frequency Hearing Loss in Cystic Fibrosis

Abstract Purpose: The purpose of this study is to better understand the prevalence of ototoxicity-related hearing loss and its functional impact on communication in a pediatric and young adult cohort with cystic fibrosis (CF) and individuals without CF (controls). Method: Observational, cross-sectional investigation of hearing function in children, teens, and young adults with CF (n = 57, mean = 15.0 yr.) who received intravenous aminoglycoside antibiotics and age- and gender-matched controls (n = 61, mean = 14.6 yr.). Participants completed standard and extended high frequency audiometry, middle ear measures, speech perception tests, and a hearing and balance questionnaire. Results: Individuals with CF were 3 to 4 times more likely to report issues with hearing, balance, and tinnitus and performed significantly poorer on speech perception tasks compared to controls. A higher prevalence of hearing loss was observed in individuals with CF (57%) compared to controls (37%). CF and control groups had similar proportions of slight and mild hearing losses, however individuals with CF were 7.6 times more likely to have moderate and greater degrees of hearing loss. Older participants displayed higher average EHF thresholds, with no effect of age on average SF thresholds. Although middle ear dysfunction has not previously been reported to be more prevalent in CF, this study showed that 16% had conductive or mixed hearing loss and higher rates of previous otitis media and pressure equalization (PE) tube surgeries compared to controls. Conclusions: Individuals with CF have a higher prevalence of conductive, mixed and sensorineural hearing loss, poorer speech-in-noise performance and higher rates of multiple symptoms associated with otologic disorders (tinnitus, hearing difficulty, dizziness, imbalance and otitis media) compared to controls. Accordingly, children with CF should be asked about these symptoms, receive baseline hearing assessment(s) prior to treatment with potentially ototoxic medications, and at regular intervals thereafter in order to provide otologic and audiologic treatment for hearing and ear-related problems to improve communication functioning.