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However, it is unclear whether baseline audiometric data was taken into account for each of the reported cases in Maddox et al and Khan et al,.

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Khan et al also indicates that 4 of the cases reported by Maddox et al were in fact previously diagnosed with otologic disease, indicating that the reported data might be confounded by other factors such as pre-existing co-morbidities.

In particular, the target population older adults for PDE 5 i prescriptions are at an increased risk for age-related hearing loss presbycusis.

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