Conflict of interest: Nothing to declare.
Audiologic and vestibular assessment in patients with β-thalassemia major receiving long-term transfusion therapy
Article first published online: 19 AUG 2013
© 2013 Wiley Periodicals, Inc.
Pediatric Blood & Cancer
Volume 60, Issue 12, pages 1963–1966, December 2013
How to Cite
Chao, Y.-H., Wu, K.-H., Lin, C.-Y., Tsai, M.-H., Peng, C.-T., Wu, H.-P. and Lin, C.-D. (2013), Audiologic and vestibular assessment in patients with β-thalassemia major receiving long-term transfusion therapy. Pediatr. Blood Cancer, 60: 1963–1966. doi: 10.1002/pbc.24699
Yu-Hua Chao and Kang-Hsi Wu contributed equally to this work.
- Issue published online: 8 OCT 2013
- Article first published online: 19 AUG 2013
- Manuscript Accepted: 24 JUN 2013
- Manuscript Received: 11 FEB 2013
- Chung Shan Medical University Hospital. Grant Number: CSH-2013-A-006
- China Medical University. Grant Number: CMU-98-NTU-13
- China Medical University Hospital. Grant Number: DMR-96-097
- Taiwan Department of Health Clinical Trial and Research Center of Excellence. Grant Number: DOH102-TD-B-111-004
Life-long transfusion therapy with chelators is a treatment choice for patients with β-thalassemia major. Some investigators have proposed auditory impairment related to the use of deferoxamine, but the mechanisms remain unclear and whether or not deferiprone has similar side effects needs to be evaluated.
Thirty-seven patients with β-thalassemia major who received regular transfusion in our hospital were enrolled. Chelation agents, including deferoxamine and deferiprone, were used. To assess audiologic function, otoscopy, pure tone audiometry (PTA), tympanometry, transient evoked oto-acoustic emission (TEOAE), and auditory brainstem response (ABR) were conducted. Bithermal caloric test was performed to evaluate vestibular function.
All of the 37 patients had normal findings on otoscopic evaluation and their tympanograms were type A. Thirteen patients (35.1%) had hearing impairment at one or more frequencies as detected by PTA. Compared to those without hearing impairment, patients with hearing impairment had lower serum ferritin levels (P = 0.01). Seven of 21 patients (33.3%) failed to pass the TEOAE, while 13 (61.9%) had abnormal ABR findings. Sixteen patients (80%) had canal paresis in the caloric test.
The incidence of auditory impairment and vestibular dysfunction was high in patients with β-thalassemia major receiving long-term transfusion therapy. Potential lesions of auditory impairment may exist anywhere along the auditory pathway, from the inner ear to the brainstem. Lower serum ferritin levels may be associated with hearing impairment. Therefore, regular check-ups of serum ferritin levels and periodic audiologic assessment are mandatory. Pediatr Blood Cancer 2013;60:1963–1966. © 2013 Wiley Periodicals, Inc.