Delayed Detection of Bilateral High-Frequency Sensorineural Hearing Loss Following Childhood Cisplatin Therapy: A...

Cisplatin is a widely used chemotherapeutic agent in pediatric oncology; however, it is well known for its marked ototoxicity. While hearing impairment typically emerges during or soon after therapy, progressive or previously undetected auditory dysfunction may occasionally present years later. The reported case involves an 11-year-old boy who previously received cisplatin-based chemotherapy for hepatoblastoma and was first identified as having bilateral sensorineural hearing loss 9 years after completion of treatment. Pure-tone audiometry revealed bilateral elevation of high-frequency thresholds without an air-bone gap, and distortion product otoacoustic emissions (DPOAE) were absent at high frequencies. Auditory brainstem responses (ABRs) demonstrated elevated thresholds at 4 kHz, and neuroimaging showed no structural abnormalities of the cochlea or auditory nerve. Expanded genetic testing revealed no pathogenic variants associated with hereditary hearing loss. Although the exact etiology could not be definitively established, the audiologic pattern and treatment history suggested that cisplatin may have contributed to the hearing loss. This case highlights the need for long-term hearing surveillance in childhood cancer survivors, as progressive or previously undetected deficits may not become clinically apparent until many years after treatment.