The Common Toxicity Criteria (CTC) define adverse events following cancer therapy. It was designed for use in clinical trials of different therapeutic regimens. It can be used to grade adverse effects on the ears and hearing.
Types of auditory or hearing adverse events:
(1) external auditory canal
(2) inner ear or hearing
(3) middle ear or hearing
(4) other
NOTES:
(1) Conduction hearing loss is graded with the middle ear adverse effects.
(2) Earache is graded in the "Pain" category.
(3) Changes to the external ear (pinna) is graded with radiation dermatitis (dermatology/skin).
Grade 0: normal or no change
|
Type of Adverse Event |
Finding |
Grade |
|
external auditory canal |
external otitits with erythema or dry desquamation |
1 |
|
|
external otitis with moist desquamation |
2 |
|
|
external otitis with discharge; mastoiditis |
3 |
|
|
necrosis of the canal, soft tissue or bone |
4 |
|
middle ear or hearing |
serous otitis without subjective decrease in hearing |
1 |
|
|
serous otitis or infection requiring medical intervention; subjective decrease in hearing; rupture of tympanic membrane with discharge |
2 |
|
|
otitis with discharge, mastoiditis or conductive hearing loss |
3 |
|
|
necrosis of the canal, soft tissue or bone |
4 |
|
inner ear or hearing |
hearing loss on audimetry only |
1 |
|
|
tinnitus or hearing loss not requiring hearing aid or treatment |
2 |
|
|
tinnitus or hearing loss correctable with hearing aid or treatment |
3 |
|
|
severe unilateral or bilateral hearing loss (deafness) that is uncorrectable |
4 |
|
other |
mild |
1 |
|
|
moderate |
2 |
|
|
severe |
3 |
|
|
life-threatening or disabling |
4 |
where:
• I assume that "inner ear" refers to the internal ear (osseous and membranous labyrinths, page 1377, Gray's Anatomy, 38th edition, 1995).
Specialty: Hematology Oncology, Otolaryngology
ICD-10: ,
