Chauke Tlangelani Nyeleti, Khoza-Shangase Katijah
Department of Audiology, School of Human and Community Development, University of the Witwatersrand, Johannesburg, South Africa.
Indian J Otolaryngol Head Neck Surg. 2025 Mar;77(3):1238-1247. doi: 10.1007/s12070-024-05299-y. Epub 2025 Jan 9.
Paediatric cancer patients receiving platinum-based chemotherapy are at high risk of ototoxicity, often resulting in irreversible hearing loss. In South Africa, where healthcare resources are limited, routine audiological monitoring for this vulnerable population remains challenging, potentially leading to undiagnosed and untreated hearing impairments. To investigate hearing function in paediatric patients with cancer in South Africa. A descriptive, retrospective record review was conducted using patient data from two tertiary hospitals in Johannesburg: Chris Hani Baragwanath Academic Hospital and Charlotte Maxeke Johannesburg Academic Hospital. Audiological records for 47 paediatric cancer patients (ages 5-18) who had undergone baseline and follow-up hearing assessments were analysed. Descriptive and inferential statistics were used to examine hearing thresholds, tympanometry, and DPOAE results, with logistic regression assessing the association between cisplatin treatment and hearing loss. The study found that 36.2% of patients experienced high-frequency sensorineural hearing loss post-treatment, with significant threshold shifts at 4000-8000 Hz. Tympanometry indicated normal middle ear function in 87% of follow-up assessments, suggesting primarily cochlear damage. Logistic regression showed a significant association between cisplatin treatment and hearing loss, with an odds ratio of 3.18 ( = 0.003). DPOAE results further confirmed outer hair cell dysfunction, particularly in high frequencies, among patients who developed hearing loss. A substantial proportion of paediatric cancer patients in South Africa experience high-frequency hearing loss due to ototoxic treatments. These findings highlight the need for routine, standardized audiological monitoring protocols, particularly in resource-limited settings. Implementing early detection and management strategies can help mitigate the impact of hearing loss on language development, education, and quality of life in this vulnerable population.
接受铂类化疗的儿科癌症患者面临耳毒性的高风险,常常导致不可逆的听力损失。在医疗资源有限的南非,对这一弱势群体进行常规听力监测仍然具有挑战性,这可能导致听力障碍未被诊断和治疗。为了调查南非儿科癌症患者的听力功能。使用约翰内斯堡两家三级医院(克里斯·哈尼·巴拉格瓦纳特学术医院和夏洛特·马克西克·约翰内斯堡学术医院)的患者数据进行了描述性回顾性记录审查。分析了47名接受了基线和随访听力评估的儿科癌症患者(5 - 18岁)的听力记录。使用描述性和推断性统计来检查听力阈值、鼓室图和畸变产物耳声发射(DPOAE)结果,采用逻辑回归评估顺铂治疗与听力损失之间的关联。研究发现,36.2%的患者在治疗后出现高频感音神经性听力损失,在4000 - 8000赫兹处有明显的阈值变化。鼓室图显示87%的随访评估中耳功能正常,表明主要是耳蜗损伤。逻辑回归显示顺铂治疗与听力损失之间存在显著关联,优势比为3.18(P = 0.003)。DPOAE结果进一步证实了发生听力损失的患者中存在外毛细胞功能障碍,尤其是在高频。南非相当一部分儿科癌症患者因耳毒性治疗而出现高频听力损失。这些发现凸显了在资源有限的环境中,特别是需要常规、标准化的听力监测方案。实施早期检测和管理策略有助于减轻听力损失对这一弱势群体的语言发展、教育和生活质量的影响。