Veterans Affairs

Portable, non-invasive testing device for emerging inner ear damage

Identification and monitoring of ototoxic-induced hearing loss and sensorineural damage

Medical & Biotechnology

(a) Test subject evaluating their hearing using the OtoID system. (b) Young normal hearing baseline testing—OtoID (automated and manual modes) compared to a nonportable Grason–Stadler Model 61 (GSI-61) audiometer with an extended HF module (up to 16 kHz).

Monitoring of high-frequency hearing loss can be an effective means for early detection of hearing problems, including those caused by ototoxicity (drug or chemical-related damage to the inner ear) which can occur during chemotherapy. Through early detection, for example, oncologists and others can adjust drug dosages or, alternatively, switch to medications that are less ototoxic.

Despite substantial evidence and clear implications that preventing significant post-treatment hearing loss improves outcomes for patients, early identification and monitoring practices have not been implemented as a standard of care in most medical centers largely due to limitations in audiometric testing equipment. Currently available equipment requires patients to be seen in an audiology clinic for testing in a sound-attenuated room, which is generally not practical for patients undergoing treatment for cancer since these individuals often are severely ill or fatigued, or else live in rural areas and where it is not realistic to expect them to return to the clinic to have their hearing tested.

The above issues are addressed with a portable audiometer developed by VA researchers that is capable of automatic or manual (by an audiologist) operation, designed with precision pure-tone stimulus generation up to 20 kHz, and able to remotely transfer health status information to a healthcare professional.

The ototoxicity identification (OtoID) system offers mobile, full-frequency-range, auditory testing which can provide detection of changes in hearing sensitivity including early detection of ototoxicity. It can be used efficiently in remote locations such as hospital wards, outpatient clinics, industrial settings, and patient homes. OtoID can also be used to monitor for any hearing change from other damaging sources, such as noise overexposure, and also perform general audiometric hearing threshold testing at any desirable range, such as up to 20 kHz which is generally considered to be the upper limit of the audible range for humans.

OtoID includes a wireless cellular modem capable of notifying a remote health care professional in the event that a significant change in hearing has occurred in the patient. The system was evaluated on test subjects within a sound-proof booth, a noisy hospital ward, and within their homes.

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