Hearing Loss among Children Treated with Chemotherapy at Paediatric Oncology Department in Tanzania

Abstract

Chemotherapy-induced hearing loss bears significant impairment of skills, language development, and cognitive performance in children. Hearing loss pattern is mostly bilateral and sensorineural, affecting high frequencies above 8 kHz, which is important in speech discrimination and background noise perception. Pathophysiology is related to damage to the basal cochlea outer hair cell, which can progress to those in the apical turn. Despite challenges encountered during monitoring chemotherapy ototoxicity in children, monitoring is very advantageous since it guides in the early identification of hearing loss and provides proper intervention such as treatment interruption, dose modification, and suspension of drugs. This study aimed to determine the prevalence and pattern of hearing loss among children treated with chemotherapy at the paediatric department in a Tertiary hospital. This was a prospective longitudinal study. A total of 52 participants were enrolled, whereby hearing assessment was done before and after receiving two cycles of chemotherapy. Tympanometry was done after otoscopic examination in all participants, play and pure tone audiometry for participants aged 2 to 6 years and 7 years, respectively, and a destruction test for those below 2 years of age. Statistical Package for Social Science (SPSS) version 26 was used to obtain cross-tabulations. Fifty-two participants with a mean age of 6.6±2.3 years were enrolled in the study. There was a male preponderance with a male-to-female ratio of 3:1. Prevalence of hearing loss after chemotherapy was 15.4%. The pattern of hearing loss was predominantly bilateral, high frequency, and sensorineural type of hearing loss. Nasopharyngeal tumours were related to hearing loss as compared to other tumour sites. Hearing loss was frequently associated with the use of cisplatin as compared to vincristine and carboplatin. The commonly used chemotherapies such as cisplatin, carboplatin, and vincristine can cause hearing loss, which can affect the quality of life and therefore require audiological monitoring