Cisplatin-Associated Ototoxicity: A Review for the Health Professional

Table 4

Clinical significance and limitations of HFA and OAEs.

HFA (>8kHz)	OAEs
Clinical significance for ototoxicity
(i) HFA is considered to be the most sensitive test to identify ototoxic hearing loss [8, 55, 75].	(i) OAES is considered a noninvasive objective measure of cochlear outer hair cell function [76].
(ii) HFA is not as affected by middle ear pathologies as OAEs [11].	(ii) DPOAEs can be regarded as a more sensitive measure for the early detection of hearing loss than conventional pure tone audiometry [44].
(iii) The criteria of change for ototoxicity is established [11].	(iii) OAEs is time efficient [11].
	(iv) DPOAEs provide frequency specific information [67].
Limitations
(i) HFA is not standardised [11].	(i) OAEs are significantly affected by middle ear pathology [37].
(ii) HFA is not commonly used, due to the need for additional equipment such as circum-aural headphones [77].	(ii) There is no universal value for the criteria of change indicating ototoxicity [76].
(iii) HFA may not always be applicable, as patients with hearing loss in the conventional frequency range may not have measurable hearing in the extended high frequency range [78].	(iii) OAEs are absent in patients with moderate degrees of hearing loss [67].
(iv) Test efficiency may be affected due to HFA being time consuming [70].	(iv) OAEs have a limited frequency range (generally up to 8000 Hz) [67].