[Hearing loss due to chemotherapy and radiation therapy in young children]

Modern treatment of pediatric cancer patients has improved survival and life expectancy. However, treatment is associated with significant side-effects, including hearing loss. Hearing impairment has an important impact on language, communication and social skills, as well as on academic performance in school.

1. Characterize hearing loss caused by treatment of pediatric cancer. 2. Define the impact of hearing loss on language development. 3. Describe techniques for intervention.

A retrospective review of ten children averaging five years of age who were referred to MICHA, a center specializing in treating hearing impaired children. For each child, at least four hearing tests were obtained, various language acquisition tests administered and methods of interventions recorded.

All the subjects had high-tone symmetric sensorineural hearing loss; at 4000 Hz it reached 80 dB HL. Low frequency tones were better preserved. Pure-tone thresholds were worse than speech reception thresholds. Hearing aids improved hearing thresholds. Nine out of the ten children experienced a delay in language acquisition. The treatment plan included: hearing aids, hearing training, intervention in language and communication skills, emotional support and preparation for elementary school.

Hearing loss amongst pediatric cancer patients as a consequence of treatment is extremely common. Delays in acquisition of language skills are seen in the majority of these children.

Pediatric cancer patients should be referred to a proper diagnostic and intervention program. They are likely to benefit from monitoring the hearing before, during and after treatment, and from interventions to improve their hearing, language and communication skills. In addition, audiometry and otoacoustic emissions should be used to identify early damage to the inner ear. Noise and further exposure to ototoxic medications should be avoided.