Program in Audiology and Communication Sciences, Washington University School of Medicine, St. Louis, Missouri, USA.
Department of Audiology, St. Louis Children's Hospital, St. Louis, Missouri, USA.
Pediatr Blood Cancer. 2022 Feb;69(2):e29437. doi: 10.1002/pbc.29437. Epub 2021 Dec 2.
We sought to estimate the frequency of hearing screening failures in pediatric cancer survivors at low risk for hearing loss and evaluate the feasibility of administering screenings in this population.
Survivors in the St. Louis Children's Hospital Late Effects Clinic were recruited. Eligibility included (a) diagnosis of a pediatric cancer treated without platinum chemotherapy or cranial radiation, (b) at least 6 months from completion of therapy, (c) between the ages of 7 and 18 years, (d) cognitively/behaviorally able to participate, and (e) English speaking. Behavioral hearing screenings from 1000 to 8000 Hz were performed by trained personnel using a calibrated audiometer. A failed screen was defined by a participant not responding to two or more of the three screening attempts for at least one frequency in at least one ear.
One hundred nine patients met eligibility criteria with 78 enrolled (71.5%). Diagnoses included leukemia (57.7%), sarcoma (11.5%), Wilms tumor (14.1%), lymphoma (12.8%), and other solid tumors (3.9%). The median age was 13.2 years (Q1-Q3: 9.6-15.4) and the median time from treatment completion was 3.7 years (Q1-Q3: 2.3-7.4). Eighteen patients (23%) failed the hearing screen (95% CI: 14%-34%). No demographic or treatment-related variables were significantly correlated to screening failure. Six screen failures (33%) underwent formal audiology assessments, with three demonstrating unilateral hearing loss: two conductive and one sensorineural.
A significant fraction of pediatric cancer survivors at low risk for hearing loss failed hearing screening. Broader use of hearing screening should be considered.
我们旨在评估低听力损失风险的儿科癌症幸存者听力筛查失败的频率，并评估在该人群中进行筛查的可行性。
我们招募了圣路易斯儿童医院后遗症诊所的幸存者。入选标准包括：（a）诊断为未经铂类化疗或颅放疗治疗的儿科癌症；（b）治疗结束后至少 6 个月；（c）年龄在 7 至 18 岁之间；（d）认知/行为能力能够参与；（e）会说英语。经过培训的人员使用校准听力计对 1000 至 8000 Hz 的行为听力进行筛查。如果至少一只耳朵的至少一个频率的三次筛查尝试中，有两个或两个以上未得到参与者的回应，则定义为筛查失败。
共有 109 名患者符合入选标准，其中 78 名（71.5%）患者入选。诊断包括白血病（57.7%）、肉瘤（11.5%）、肾母细胞瘤（14.1%）、淋巴瘤（12.8%）和其他实体瘤（3.9%）。中位年龄为 13.2 岁（Q1-Q3：9.6-15.4），从治疗结束到中位时间为 3.7 年（Q1-Q3：2.3-7.4）。18 名患者（23%）听力筛查失败（95%CI：14%-34%）。没有发现任何人口统计学或治疗相关变量与筛查失败有显著相关性。6 例筛查失败（33%）患者进行了正式的听力学评估，其中 3 例表现为单侧听力损失：2 例传导性，1 例感音神经性。
低听力损失风险的儿科癌症幸存者中，有相当一部分听力筛查失败。应考虑更广泛地使用听力筛查。
