By Mariame Nehme, student of the Master in Clinical Audiology and Hearing Therapy

Abstract

Cisplatin remains a key component of pediatric oncology, significantly improving survival rates in solid tumors such as neuroblastoma, hepatoblastoma, medulloblastoma, and osteosarcoma; however, its effectiveness is often limited by high rates of irreversible ototoxicity. This review compiles evidence on cisplatin-related auditory damage, highlighting the importance of early, structured, and age-appropriate audiological monitoring. Mechanistic studies show that cisplatin ototoxicity is driven by oxidative stress, mitochondrial dysfunction, and cell death in cochlear hair cells, worsened by the inner ear’s limited blood supply and detoxification abilities. Clinically, hearing loss in children affects more than just sensation; it impacts language learning, cognitive development, academic success, and social interaction. Epidemiological data report incidence rates ranging from 20% to 70%, with risk factors including age, total dose, genetic predisposition, and exposure to other ototoxic agents. Monitoring techniques, such as otoacoustic emissions (OAE), auditory brainstem response (ABR), pure-tone audiometry (PTA), and high-frequency audiometry (HFA), each have specific benefits but are often underused or inconsistently applied. Guidelines from organizations like ASHA, the Children’s Oncology Group, and SIOP emphasize the need for baseline and ongoing assessments, yet practice disparities remain, especially in resource-limited settings. Recent innovations like sodium thiosulfate offer pharmacological protection but do not eliminate the need for continued surveillance. This review advocates for a tiered, age-specific monitoring approach to enable early detection, treatment adjustments, and prompt rehabilitation. In pediatric cancer care, protecting hearing is crucial not only for quality of life but also for supporting the developmental progress of survivors.

Keywords: cisplatin, ototoxicity, pediatric, oncology, surveillance.

Download the full Research Work: Nehme, M. (2025). Monitoring Ototoxicity in Pediatric Oncology: A Literature Review on Audiological Surveillance During Cisplatin Therapy. SAERA