Article

Prevention and rehabilitation of hearing loss and tinnitus, the two most commonly
awarded service-connected disabilities, are high priority initiatives in the
Department of Veterans Affairs (VA). At least 4,000 Veterans, most with
significant hearing loss, will receive cisplatin this year, with more than half
sustaining permanent hearing shift and nearly 40% developing new tinnitus. With
improved survivability following cancer treatment, Veterans treated with
cisplatin are approached with the dual goals of effective treatment and preserved
quality of life. This article describes COMP-VA, a comprehensive ototoxicity
monitoring program developed for VA patients receiving cisplatin. The program
includes an individualized pretreatment prediction model that identifies the
likelihood of hearing shift given cisplatin dose and patient factors. It supports
both manual and automated hearing testing with a newly developed portable
audiometer capable of performing the recommended procedures on the chemotherapy
unit during treatment. It also includes objective methods for identifying outer
hair cell changes and predicting audiogram changes using distortion-product
otoacoustic emissions. We describe this program of evidence-based ototoxicity
monitoring protocols using a case example to give the reader an understanding of
how this program would be applied, along with a plan for future work to
accomplish the final stages of program development.

Langue : ANGLAIS