Evaluating Hearing Loss in Patients Undergoing Second Line Anti Tubercular Treatment

Abstract

To estimate the prevalence of Sensorineural hearing loss and evaluate the severity of hearing impairment in patients undergoing second line injectable antitubercular treatment. To study the effects of duration of treatment, dose schedule and demographic factors which aggravates anti TB drug induced ototoxicity. Design–prospective and retrospective study Setting-ENT & TB clinic at our hospital and TB Hospital of Subject-18–50 year age , diagnosed MDR or XDR TB Method–baseline puretone audiometry was done of all patients. all patients divided in 3 group depending on aminoacid (amikacin , kanamycin, capreomycin). Follow up PTA was done at 3rd month, 6th month and 6 month after stopping treatment 35.48% of Group 1 (kanamycin) patients show High frequency hearing loss and 16% of patient have both high and low frequency hearing loss High frequency hearing loss 21% of Group 2 (amikacin) patients show High frequency hearing loss and 5% of patient have both high and low frequency hearing loss 20% of Group 3 (capreomycin) patients show High frequency hearing loss with no patient resulted low frequency loss Patients treated FOR MDR-TB develop significant adverse effects. Clinicians must consider risk benefit analysis during treatment as ototoxicity of injectable aminoglycoside ATT is permanent. Early detection of hearing loss through pure tone audiometry helps preventing and progression of hearing loss without compromising the treatment.