An audit of UK audiological practice in specialist paediatric oncology centres regarding hearing assessment of children at risk of ototoxicity due to chemotherapy

Abstract

Objective Platinum-based chemotherapy drugs are associated with substantial ototoxicity. The hearing of children treated with these drugs should be closely monitored. Method A questionnaire was sent out to the 19 audiology departments associated with national paediatric cancer specialist centres in the UK looking at current practice in ototoxicity monitoring. Results Responses were received from 17 of 19 centres (89 per cent). All offered some form of audiometric monitoring service. Extended high-frequency testing (9–20 kHz) was only utilised by 7 services (29 per cent). A majority of respondents were reluctant to consider self-test devices in paediatric ototoxicity monitoring (n = 9; 53 per cent). Provision of long-term audiological follow up is sporadic with only 4 (23 per cent) respondents keeping all children with normal hearing under review once treatment is completed. Conclusion While some good practice in paediatric ototoxicity was identified, opportunities exist to improve clinical practice and protocols, promote multidisciplinary team working and to utilise technologies such as extended high frequency and self-test audiometry.

The long-term impacts of hearing loss, tinnitus and poor balance on the quality of life of people living with and beyond cancer after platinum-based chemotherapy: a literature review

“…It is important to test the balance of individuals LWBC, especially since falls are more common in older adults with cancer than those without [ 57 ]. Similar findings have been seen in a study of 17 pediatric oncology centres [ 58 ]. A questionnaire sent to each of these centres highlighted the low rate of long-term audiological monitoring.…”

Applications of the Grading Scales for the Detection of Ototoxicity in Children after Treatment of Neuroblastoma and Extracranial Germinal Tumor

“…It can lead to learning disabilities and problems in socializing and relating to other people. It can also result in the need for additional educational support in and out of school [Knight et al, 2005;Brown et al, 2021].…”

“…An increasing population of children and adolescents is challenged by the adverse impact of oncologic treatment on their subsequent functioning. Late multi-organ complications result from chemotherapy, radiotherapy, and surgical treatment [Brown et al, 2021;Dasgupta et al, 2021].…”

“…Potential ototoxic effects concern strictly defined groups of drugs used in oncological treatment in children. This mainly affects cisplatin, carboplatin, cyclophosphamide, vincristine, and vinblastine [Brown et al, 2021]. The severity of ototoxic side effects of these drugs depends on the patient's preonset health status, dose, ex-posure time, co-occurrence of adverse factors, use of other medications, noise exposure, age of onset, sex, race, tumor location, type of treatment used (surgery, chemotherapy, radiotherapy, megachemotherapy), and complications during treatment, renal function, as well as lifestyle and individual sensitivity Ahn and Choi, 2021;Brown et al, 2021;Olgun et al, 2021].…”

“…Clinical effects of ototoxic drugs differ depending on the site of their action (cochlear and/or atrial sensory cells, vascular striatum), caused by symptoms (tinnitus, dizziness, hearing loss), and their reversibility (temporary or permanent hearing loss). Chemotherapeutic agents can cause bilateral, progressive, irreversible sensorineural hearing loss (manifested by loss of loudness and clarity of the perceived sound) or bilateral, irreversible hearing loss [Brown et al, 2021].…”