[Hearing evaluation in children during chemotherapy]

Area of Science:

• Otoacoustic Emissions
• Audiology
• Pediatric Oncology

Background:

• Chemotherapy poses a significant risk of ototoxicity, potentially leading to irreversible hearing damage.
• Early detection of chemotherapy-induced ototoxicity is crucial for preserving hearing function in pediatric patients.
• Standard audiological assessments may not always identify subtle, early-stage cochlear changes.

Purpose of the Study:

• To evaluate the clinical utility of Distortion Product Otoacoustic Emissions (DPOAEs) as an early indicator of ototoxicity in children undergoing chemotherapy.
• To assess the sensitivity of DPOAEs in detecting subclinical cochlear changes induced by chemotherapy.
• To establish DPOAEs as a valuable tool for monitoring hearing in pediatric patients receiving ototoxic treatments.

Main Methods:

• A cohort of 7 children with acute lymphoblastic leukemia (ALL) was studied.
• Audiometry, emission audiometry, and DPOAEs (2f1-f2 with L1=65, L2=60 dB SPL) were measured before and after each chemotherapy cycle.
• DP-gram amplitudes were compared between baseline and post-chemotherapy measurements to assess cochlear function changes.

Main Results:

• DPOAE measurements demonstrated high sensitivity in detecting early alterations in cochlear function.
• Significant changes in DPOAE amplitudes were observed following chemotherapy protocols.
• DPOAEs proved more sensitive than traditional audiometry in identifying incipient ototoxicity.

Conclusions:

• Distortion Product Otoacoustic Emissions are a sensitive and reliable method for the early detection of chemotherapy-induced ototoxicity.
• Regular DPOAE monitoring is recommended for pediatric patients undergoing chemotherapy to preserve hearing.
• Integrating DPOAEs into audiological surveillance can improve hearing preservation strategies in oncology.