Investigating Hearing Function in Paediatric Patients with Cancer in South Africa.

Abstract

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 (p = 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.