Auditory Evaluation with Pure Tone Audiometry and DPOAE in Kanamycin Treatment of Multidrug-Resistant Tuberculosis

Background: Kanamycin treatment is mainly used in multidrug-resistant tuberculosis (MDR-TB) patients. Hearing impairment associated along with the treatment leads to be permanently. Audiology assessments and monitoring may benefits to detect early on hearing loss. This study aimed to determine the evaluation of hearing alteration after kanamycin injection in the first month treatment.

Method: We conducted a prospective study, observational longitudinal analytic with pre and post design in patients treated with kanamycin-based regimens in MDR-TB Outpatients Pulmonology Department Dr. Soetomo general hospital Surabaya. Assessment of hearing result using Pure Tone Audiometry and DPOAE, compared between baseline data and after 4 weeks treatments. Statistical analysis for hearing threshold and cochlear dysfunction based on overall frequency and specific frequency DPOAE examination, using Wilcoxon ranks test and Mc Nemar test.

Results: A total of 15 patients (8 males and 7 females) with confirmed diagnosis of MDR-TB were included in this study conducted within 3 months in 2018. There were 15 ears represented with based line and compared to 4 weeks after treatment, showed on Audiometry and DPOAE on overall frequencies, found no significant difference (p > 0.05), but in DPOAE at frequency of 10,000 Hertz (Hz) was found a significant difference (p = 0.002).

Conclusion: DPOAE at high frequency (10,000 Hz) may benefits for early detection on hearing impairment. A baseline data with DPOAE is recommended, besides Audiometry for ototoxicity monitoring in Kanamycin treatment in MDRTB patients.