Liaqat Ali, Agha Shabbir Ali, Samra Zahra, Fatima Sajjad, Mahwish Faizan, Rabia Wali.
Effects of cytotoxic chemotherapy on auditory status in children.
Pak Paed J Jan ;33(4):223-7.

Objective: To evaluate the frequency and severity of hearing loss in children treated with cytotoxic chemotherapy. Study design: Descriptive Setting: The study was carried out jointly by The departments of Paediatric Audiology and Paediatric Oncology, The Children’s Hospital & The Institute of Child Health, Lahore. Duration: October 2003 to December 2006. Material and methods: Hearing assessment was carried out prospectively for fifty-six patients with various malignancies aged between 38 days and 14 years. Subjects were at different stages of treatment with cytotoxic chemotherapy was carried out prospectively. Standard doses of known ototoxic agents included Cisplatin 80mg/m2 and Carboplatin 500mg/m2 per cycle. Repeat audiology assessment was done after 6 months of therapy. Audiology assessment was done using pure tone audiometry (PTA), otoacoustic emission analysis (OAE), auditory brainstem response (ABR), distraction test, and visual reinforcement audiometry (VRA). Results: Of the 56 patients studied, 24 (42.8%) developed hearing impairment. Sensorineural hearing loss was the more frequent, seen in 23.2% of children during the course of chemotherapy. Patients treated with platinum compounds had significantly higher ototoxicity compared to the ones who did not receive these compounds. Graded according to severity, 12 (50%) developed mild hearing loss, 7 (29.2%) had moderate, 1 (4.2%) had severe and 4 (16.7%) had profound degree hearing loss. Conclusions: Sensorineural hearing impairment was commonly found in children on chemotherapy, particularly those on platinum compounds. Hearing impairment was reversible over 6 months in patients who were not treated with platinum agents.

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