Ototoxic impact of cisplatin in pediatric oncology patients

Objective: To describe hearing changes in a group of 28 children (age range , 8-180 mo) undergoing protocol-based cisplatin therapy, Methods: Conventio nal, play audiometry, visual reinforcement audiometry (VRA), immittance aud iometry, transient click evoked otoacoustic emissions (OAEs), and auditory brainstem response (ABR) evoked potentials were used to assess peripheral s ensitivity and for threshold determination. Results: Bilateral symmetrical high-frequency sensorineural hearing loss was noted in 9 of the 28 children (26%). Hearing loss was evident as early as 1 month after chemotherapy and as late as 50 months and was not dependent on individual or cumulative dos age of cisplatin, Conclusions: 1) Presence of sensorineural hearing loss wa s independent of individual and/or cumulative dosage of cisplatin; 2) audio logic assessment should be incorporated into a child's periodic medical eva luations after chemotherapy treatment, as onset of sensorineural hearing lo ss cannot be predicted; 3) personal hearing aids may be indicated for those children with hearing loss affecting the low- to mid-frequencies; a person al assistive listening device (frequency modulated system) may be more appr opriate for losses above 3000 Hz; and 4) evaluation and intervention by a s peech-language pathologist may be indicated to address possible articulatio n or language development problems consequent to hearing loss.