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Ototoxicity Monitoring in VA Healthcare: DPOAE Levels and Threshold Shifts

Graph showing DPOAE level changes for a 5,040 Hz stimulus in relation to cumulative drug dose. Criteria for valid responses and threshold shift predictions within ototoxicity risk assessment range are illustrated. Cisplatin effects at 190mg dose examined. Study explores a comprehensive monitoring program using otoscopic and tympanometric results.

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Ototoxicity Monitoring in VA Healthcare: DPOAE Levels and Threshold Shifts

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  1. Figure 5. Distortion-product otoacoustic emission (DPOAE) level plotted as function of L2 stimulus input level for f2 of 5,040 Hz from case study 1 stratified by cumulative drug dose. Measurements failing to meet criteria for valid response of +6 dB greater than combined noise and system distortion are indicated by “X” on figure corresponding to that input level. Gray line identifies monitor visit at which estimated American Speech-Language-Hearing Association-significant threshold shift will occur within sensitive range for ototoxicity using ototoxicity risk assessment. DPOAE level changes at cisplatin dose of 190 mg to inputs of 35–45 dB sound pressure level (SPL) were not clinically significant (5 dB). Otoscopic and tympanometric results were used to rule out conductive component to loss. Konrad-Martin D, Reavis KM, McMillan G, Helt WJ, Dille M. Proposed comprehensive ototoxicity monitoring program for VA healthcare (COMP-VA). J Rehabil Res Dev. 2014;51(1):81–100. http://dx.doi.org/10.1682/JRRD.2013.04.0092

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