Brainstem auditory pathway of children with acute lymphoid leukemia on chemotherapy with methotrexate.

Renata Aparecida Leite,Leticia Cortez Neto,Nayara Pereira Santos,Carla Gentile Matas,Sandro Luiz De Andrade Matas,Jéssica Sales Vosgrau,Vicente Odone Filho

doi:10.1590/0004-282x20190139

Renata Aparecida Leite, Leticia Cortez Neto + Show 5 more

Open Access

https://doi.org/10.1590/0004-282x20190139

Copy DOI

Abstract

Investigate the auditory pathway in the brainstem of children with acute lymphoblastic leukemia submitted to chemotherapy (by intravenous or intrathecal infusion). Fourteen children aged between 2 and 12 years with diagnosis of acute lymphoid leukemia were evaluated. The following procedures were used: meatoscopy, acoustic immitance measurements, tonal audiometry, vocal audiometry, transient otoacoustic emissions, and auditory brainstem response. From the 14 children with normal auditory thresholds, 35.71% showed an alteration in auditory brainstem response, with a predominance of hearing impairment in the lower brainstem. It was found that 80% of the children with alteration had used intrathecal methotrexate less than 30 days and that 40% had the highest cumulative intravenous methotrexate doses. Children with acute lymphoblastic leukemia submitted to chemotherapy, present auditory pathway impairment in the brainstem, with a predominance of a low brainstem.

Highlights

The Brainstem auditory evoked potential (BAEP) results showed that of the 14 children evaluated, 35.71% (1, 2, 4, 8, 11) had some type of alteration, and the predominant type was auditory impairment in the lower brainstem (80%) (Tables 1, 2 and 3)
We observed that 60% of children (1, 2, 4) who presented altered BAEPs were younger than 5 years old and that 80% of the children (1, 2, 8, 11) with alterations had received MTX intrathecally less than 30 days before (Table 1)
These findings are consistent with reports in the literature of individuals undergoing chemotherapy who have both complaints of otitis and upper airway infection[4]

Summary

Introduction

The BAEP results showed that of the 14 children evaluated, 35.71% (1, 2, 4, 8, 11) had some type of alteration, and the predominant type was auditory impairment in the lower brainstem (80%) (Tables 1, 2 and 3). The results of the behavioral tests obtained in the present study showed that the peripheral hearing of children at the frequencies conventionally evaluated was not impaired by chemotherapy because all children had thresholds within the normal range for their age.

Results

Conclusion