What is the most appropriate protocol for ototoxicity monitoring with DPOAEs (distortion product otoacoustic emissions)?
Answer
A good source of information on this topic is the 2009 American Academy of Audiology Clinical Practice Guideline on Ototoxicity Assessment and Monitoring available with a search on the AAA website (www.audiology.org). Briefly, set up an ototoxicity protocol with DPs recorded from at least 5 frequencies per octave over the range of 2000 to 8000 Hz, or higher frequencies if possible with your DPOAE system. An intensity paradigm of f2 = 55 dB SPL and f1 = 65 dB SPL would be appropriate. It's important to replicate or even triplicate DPgrams in the baseline recordings. Any replicable decrease in DP amplitudes for the highest frequencies would be considered as evidence of ototoxicity, even if with the changes the DPs are still within a normative region. DP findings should be immediately reported to the managing physician.
James W. Hall III, PhD is an internationally recognized audiologist with 40-years of clinical, teaching, research, and administrative experience. He received his Ph.D. in audiology from Baylor College of Medicine under the direction of James Jerger. During his career, Dr. Hall has held clinical and academic audiology positions at major medical centers. Dr. Hall now holds appointments as Professor at Salus University and the University of Hawaii, and as Extraordinary Professor at the University of Pretoria South Africa. Dr. Hall is the author of over 160 peer-reviewed journal articles, monographs, or book chapters, and nine textbooks including the 2014 Introduction to Audiology Today and the 2015 eHandbook of Auditory Evoked Responses.
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