Recommendations for Age-Appropriate Testing, Timing, and Frequency of Audiologic Monitoring During Childhood Cancer Treatment: An International Society of Paediatric Oncology Supportive Care Consensus Report
JAMA Oncology
Meijer, A. J. M., van den Heuvel-Eibrink, M. M., et al. (2021).
JAMA Oncology, 7(10), 1550-1558.
This guideline provides recommendations regarding audiological monitoring for hearing loss in children undergoing ototoxic cancer treatment (e.g., platinum treatment, cranial irradiation).
International Society of Paediatric Oncology
For any child receiving ototoxic cancer treatments, baseline hearing screening should include collecting a case history and monitoring auditory function. Audiological follow-up should include testing of middle and inner ear function and checking for tinnitus symptoms. The recommended timing and frequency of monitoring during treatment varies by the treatment risk factor as follows:<br />
<ul>
<li>Hearing should be monitored at each cycle of Cisplatin for doses >50mg/m<sup>2</sup>, Carboplatin for dosages <span style="text-decoration: underline;">></span>1000mg/m<sup>2</sup>, and for other hearing risk indications.</li>
<li>Hearing should be monitored at each alternating cycle of Cisplatin for dosages <50mg/m<sup>2</sup> and optionally for Carboplatin doses <span style="text-decoration: underline;">>200-</span>1000mg/m<sup>2</sup>.</li>
<li>Optional hearing monitoring should be considered after procedures including cranial irradiation, central nervous system surgery, or cerebrospinal fluid shunt placement.</li>
</ul>
At the end of the cancer treatment, children should undergo additional monitoring.
For infants less than 6 months old who receive ototoxic cancer treatment, audiological testing should include otoscopy, tympanometry, distortion product otoacoustic emissions, and auditory brainstem response (ABR). ABR should be conducted while the infant is asleep or sedated, often conducted in combination with another planned surgery or radiologic procedure.
For children, 6 months to 3 years old, who receive ototoxic cancer treatment, audiological testing should include otoscopy, tympanometry, distortion product otoacoustic emissions, and visual reinforcement audiometry. In children, 3 to 5 years old, audiological testing should include otoscopy, tympanometry, distortion product otoacoustic emissions, and conditioned play audiometry. Children who are unable to complete behavioral testing should undergo distortion product otoacoustic emissions, auditory brainstem response, and behavioral testing appropriate for their developmental level.
In children, 5 to 18 years old, audiological testing should include otoscopy, tympanometry, and standard pure-tone audiometry. Children who are unable to complete behavioral testing should undergo distortion product otoacoustic emissions, auditory brainstem response, and behavioral testing appropriate for their developmental level.
