Hearing
Introduction
Hearing loss can be a long term complication of treatment for childhood cancer.
Follow this link for an overview about how normal hearing works
Hearing loss may be due to:
- Conductive deafness
- Problem with the transmission of sound from the air to the middle ear
- Outer or middle ear affected
- Sensorineural deafness
- Nerve conduction deafness
- Problem with the inner ear or auditory nerve
Hearing loss can cause problems with:
- Speech and language development
- Educational achievement
- Communication
- Social interactions and behavior
- Overall quality of life (QoL)
These problems are especially severe in very young children.4 Hearing loss greatly impacts their development. Ineffective communication can lead to isolation and significant difficulties with relationships at home, in the classroom and at work3,4
Causes:
The causes of hearing impairment include:
- Conductive loss
- Structural problems/scarring involving the outer and middle ear from tumor involvement or secondary to radiation therapy (RT)
- Sensorineural
- Damage to the cochlea from RT
- Drug related nerve damage:
- Platinum compound chemotherapeutic agents (cisplatin and carboplatin) have sensorineural effects most prominent in high frequency ranges (3)
- Aminoglycoside antibiotics
The risk of auditory problems is increased in patients with:
- Young age (less than 4) at time of therapy4
- Diagnosis of CNS tumor3
- Treatment with multiple ototoxic agents3
- Platinum chemotherapy in combination with RT to the ear or brain3
- Decreased renal function at time of treatment20
- Rapid IV administration of oto-toxic pharmacological agent20
- Prolonged elevated serum trough drug level20
