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Transient otoacoustic emissions in children with chronic renal failure
Insights
Children with chronic renal failure show impaired hearing, particularly those on hemodialysis. Transient otoacoustic emission testing reveals cochlear dysfunction, indicating a need for audiological monitoring in these patients.
Area of Science:
- Pediatrics
- Nephrology
- Audiology
Background:
- Chronic renal failure (CRF) affects children, potentially leading to systemic complications.
- Hearing impairment is a recognized complication in patients with renal disease.
- Early detection of hearing issues is crucial for managing developmental outcomes.
Purpose of the Study:
- To assess hearing function in children with chronic renal failure using audiological assessments and transient otoacoustic emission (TOAE) testing.
- To identify the prevalence and type of hearing loss in pediatric CRF patients.
- To evaluate the impact of hemodialysis on cochlear function.
Main Methods:
- Clinical and otoscopic examinations were performed on 34 children with CRF (27 on hemodialysis, 7 on conservative treatment) and 20 healthy controls.
- Basic audiological assessment and transient otoacoustic emission (TOAE) testing were conducted.
- Results were compared between the CRF group, hemodialysis subgroup, and controls.
Main Results:
- Four CRF patients had conductive hearing loss; five had sensorineural hearing loss.
- TOAE testing showed significantly more 'no response' (8%) and 'partial pass' (38%) results in CRF patients compared to controls (P < 0.001).
- Mean echo-level and reproducibility in TOAE were significantly lower in CRF patients, especially those on hemodialysis, indicating cochlear dysfunction.
Conclusions:
- Children with chronic renal failure exhibit a higher incidence of hearing impairment and cochlear dysfunction.
- Hemodialysis appears to negatively impact cochlear function, as evidenced by TOAE results.
- Regular audiological monitoring is recommended for pediatric patients with chronic renal failure, particularly those undergoing hemodialysis.
Abstract:
This study was conducted on 34 children with chronic renal failure: 27 on regular haemodialysis and seven on conservative treatment. Twenty normal healthy children served as controls. They were subjected to clinical examination including otoscopic examination, basic audiological assessment and transient otoacoustic emission testing (TOAE). Four patients had a conductive hearing loss and five had a bilateral moderately severe high frequency sensory neural hearing loss. TOAE testing was carried out for the rest whose ears displayed normal hearing. No response (fail) was obtained in 8% of them but in none of the controls and a partial pass response in 38% versus 10% of controls (P < 0.001). Cochlear dysfunction was significant only at low frequency levels. The mean overall echo-level and reproducibility were significantly lower in patients than in controls. The same holds true for the subgroup of patients on haemodialysis but not for those on conservative treatment. The overall echo-levels did not correlate with serum urea, creatinine, sodium or potassium.