Ototoxicity Grading

Modified on Sat, 23 Nov at 3:56 PM

Audiqueen can calculate an ototoxicity grading based on audiometric thresholds. This is used by some clinics when patients receive chemotherapy that is potentially ototoxic. Different grading systems exist and Audiqueen offers a number of them.

How to switch on the ototoxicity grading system?

In the Audiometry Format window, click on the button Manage Indices. Check the checkbox 'Add ototoxicity indices'.

This adds a number of new indices to the list:

You can use those indices like any other (see support page). However, the result will be a degree of ototoxicity ranging from 0 to 4. The terms associated with it are:

0: no ototoxicity

1: mild ototoxicity

2: moderate ototoxicity

3: severe ototoxicity

4: profound ototoxicity

How does Audiqueen determine the ototoxicity grades?

Different grading systems exist and the detailed calculation method can be found in the original scientific papers.

Brock 1991: Brock PR, Bellman SC, Yeomans EC, Pinkerton CR, Pritchard J. Cisplatin ototoxicity in children: a practical grading system. Med Pediatr Oncol. 1991; 19(4):295–300. PMID: 2056973.
Münster 2007: Schmidt CM, Bartholomaus E, Deuster D, Heinecke A, Dinnesen AG. [The "Muenster classification" of high frequency hearing loss following cisplatin chemotherapy] Die "Munsteraner Klassifikation": Eine neue Einteilung der Hochtonschwerhorigkeit nach Cisplatingabe. Hno. 2007; 55(4):299–306. https://doi.org/10.1007/s00106-005-1368-1 PMID: 16437215
CTCAE 2009, v5 (2017): U.S. Department of Health and Human Services NIoH, National Cancer Institute. Common Terminology Criteria for Adverse Events v4.0 (CTCAE): U.S. Department of Health and Human Services, National Institutes of Health, National Cancer Institute; 2009 [cited 2018]. https://ctep.cancer.gov/protocolDevelopment/electronic_applications/ctc.htm
Chang 2010: Chang KW, Chinosornvatana N. Practical grading system for evaluating cisplatin ototoxicity in children. J Clin Oncol. 2010; 28(10):1788–95. https://doi.org/10.1200/JCO.2009.24.4228 PMID: 20194861.
SIOP Boston 2012: Brock PR, Knight KR, Freyer DR, Campbell KC, Steyger PS, Blakley BW, et al. Platinum-induced oto- toxicity in children: a consensus review on mechanisms, predisposition, and protection, including a new International Society of Pediatric Oncology Boston ototoxicity scale. J Clin Oncol. 2012; 30(19):2408– 17. https://doi.org/10.1200/JCO.2011.39.1110 PMID: 22547603.

caveat 1: Ototoxicity is characterised by cochlear damage, which is manifested audiometrically by shifting bone conduction thresholds. In principle, therefore, grades should be based on bone conduction thresholds. Since these are often not measured, Audiqueen calculates grades based on air conduction thresholds. If these differ from the bone conduction thresholds, the grading is not correct!
caveat 2: Some grading systems distinguish between adults and children. In that case, Audiqueen uses the paediatric grading.