Alterations in Evoked Otoacoustic Emissions by the Use of Meglumine Antimoniate in American Tegumentary Leishmaniasis Patients

• Published in: PloS one 2017-01, Vol.12 (1), p.e0168492
• Main Authors: Oliveira Bezerra, Débora Cristina de, Oliveira de Barcelos, Renata, Carvalho de Castro, Ellen, Jardim Duarte, Claudia Cristina, de Vasconcellos Carvalhaes Oliveira, Raquel, Salgado de Sousa Torraca, Tania, de Araújo-Melo, Maria Helena, Pereira Bom Braga, Frederico, Ramos Ferreira Terceiro, Benivaldo, do Nascimento Brahim Paes, Lúcia Regina, de Oliveira Schubach, Armando, Valete-Rosalino, Cláudia Maria
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Audiometry; Audiometry, Pure-Tone; Auditory system; Auditory Threshold - physiology; Biology and Life Sciences; Brazil; Cochlea; Cochlea - drug effects; Complications and side effects; Correlation analysis; Damage; Disorders; Dosage and administration; Drug dosages; Drug therapy; Emissions; Female; Hearing; Hearing loss; High frequencies; Humans; Infectious diseases; Laboratory animals; Leishmania; Leishmaniasis; Leishmaniasis, Cutaneous - drug therapy; Longitudinal Studies; Male; Medicine; Medicine and Health Sciences; Meglumine - adverse effects; Meglumine antimoniate; Membranes; Middle Aged; Monitoring; Organometallic Compounds - adverse effects; Otoacoustic emissions; Otoacoustic Emissions, Spontaneous; Otolaryngology; Ototoxicity; Parasitic diseases; Patients; Physical Sciences; Pollution monitoring; Prospective Studies; Protozoa; Rehabilitation; Skin; Tegumentary leishmaniasis; Tinnitus; Toxicity; Vector-borne diseases; Young Adult
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0168492

Tegumentary Leishmaniasis (TL) is a neglected, non-contagious, infectious disease, caused by different protozoa species of the Leishmania genus that affects skin and mucous membranes. Meglumine Antimoniate (MA), the first drug of choice for TL treatment in Brazil, has already been associated with cochlear toxicity, which is defined as damages of the cochlea caused by exposure to chemical substances, resulting in reversible or irreversible hearing loss. Auditory monitoring for cochlear toxicity aims at the early detection of auditory disorders, enabling, when possible, hearing to be preserved or an early auditory rehabilitation. Although otoacoustic emissions (OAEs) are used in this monitoring, there is no consensus on the criteria that define cochlear toxicity by this examination. The objective of this study was to describe the characteristics of the OAEs in cochlear toxicity monitoring in TL patients using MA. Prospective and longitudinal study of auditory monitoring of 35 patients with parasitological diagnosis of TL, with liminal tonal audiometry, high frequency audiometry, immitanciometry, distortion product evoked otoacoustic emissions (DPEOAEs) and transient evoked otoacoustic emissions (TEOAEs) before treatment, at the end of treatment, one month after the end of treatment and two months after the end of treatment. 80% male, with median age of 44 years (IIQ: 22-59). In the pre-treatment evaluation: 11.4% complained of hearing loss and 20% of tinnitus, 48.6% presented auditory alterations in liminal tonal audiometry (LTA, 65.2% in high frequency audiometry (HFA), 26.6% in DPEOAE and 51.4% in TEOAE. No association was verified between genre and alterations in the EOAE examinations. We observed that patients that presented disorders in DPEOAE examinations were 17 years older than those without alterations and that patients that showed disorders in TEOAEO examinations were 34 years older than those without disorders. The presence of alterations in DPEOAE and TEOAE before beginning treatment was associated with each other and with the presence of alterations in LTA and HFA, and only DPEOAE was associated with hearing loss. We observed a significantly higher number of alterations of DPEOAE at the end of treatment than during pre-treatment and values of the ratio signal/noise significantly smaller at the end of treatment than during pre-treatment in the frequencies of 2 kHz (difference of 1.7dB; p = 0.016) and 4 kHz (difference of 2.45dB; p = 0.016) in DPE