학술논문

Clinical Observations in Patients With Cystic Fibrosis--Related Diabetes and Self-Reported Ototoxicity Symptoms.
Document Type
Article
Source
American Journal of Audiology; Mar2024, Vol. 33 Issue 1, p283-291, 9p
Subject
Treatment of hearing disorders
Academic medical centers
Self-evaluation
Benchmarking (Management)
Comparative studies
Diabetes complications
Tinnitus
Glycosylated hemoglobin
Aminoglycosides
Respiratory infections
Acquisition of data
Vestibular apparatus diseases
Cystic fibrosis
Risk assessment
Treatment effectiveness
Severity of illness index
Ototoxicity
Medical records
Questionnaires
Descriptive statistics
Research funding
Glucose tolerance tests
Antibiotics
Disease management
Comorbidity
Disease complications
Oregon
Language
ISSN
10590889
Abstract
Purpose: Persons with cystic fibrosis (PwCF) are at high risk for ototoxicity due to the routine use of intravenous aminoglycoside (IV-AG) antibiotics in respiratory infection management. Additionally, factors that contribute to ototoxicity-related symptom development and severity in PwCF are unknown. Given the increased risk of ototoxicity in people with diabetes, we explored the association between cystic fibrosis--related diabetes (CFRD) and self-reported ototoxicity symptoms (tinnitus and vestibular problems) in PwCF treated with aminoglycosides. Method: PwCF (N = 39; 25 females, 14 males; Mage = 30.1 years, SD = 10.3) were recruited from the Cystic Fibrosis Care Center at Oregon Health & Science University. Patients completed the validated questionnaires to ascertain their experiences with ototoxicity-related symptoms of tinnitus and balance function. The diagnosis of CFRD, including oral glucose tolerance testing (OGTT), insulin treatment, hemoglobin A1c, and cumulative IV-AG treatment history, was obtained through a medical chart review. Participants were classified into three groups based on their medical diagnoses via OGTT: normal glucose tolerance (NGT; control; n = 16), abnormal glucose tolerance (AGT; n = 9), and CFRD (n = 14). Participants in each group were further classified based on survey outcomes for ototoxicity-related symptoms. Results: There was a trend toward a higher proportion of patients with CFRD reporting tinnitus compared to the AGT and NGT groups, but did not meet statistical significance (§² = 2.24, p = .13). Approximately, 43% of patients with CFRD reported experiencing clinically significant tinnitus lasting > 3 min compared to 11% in the AGT group and 13% in the NGT group (§² = 3.751, p = .05). Cumulative IV-AG exposure tended to be higher in CFRD compared to other groups. High balance function was generally reported in all groups. Conclusions: Patients with CFRD have greater ototoxicity-related symptoms. Further investigation of the relationship between CF-related comorbidities and the risk of developing ototoxicity-related symptoms is warranted to improve the detection and management of ototoxicity in PwCF. [ABSTRACT FROM AUTHOR]