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Some childhood cancer survivors may experience hearing problems.
The most common conditions are hearing loss and tinnitus.
In some cases, hearing problems are temporary. In other cases, they are permanent. These conditions may happen in one or both ears.
Regular hearing evaluations after childhood cancer therapy are recommended.
If hearing loss is detected, it is important to be under the care of an audiologist or otologist, a doctor who specializes in hearing disorders.
Hearing problems, especially in young children, may lead to other issues involving speech and language, social and emotional development, and school performance.
Hearing problems start when 1 or more parts of the ear are damaged.
Hearing loss and tinnitus are the 2 main types of hearing problems in childhood cancer survivors.
The signs and symptoms of hearing loss include:
There are different types of hearing loss.
Tinnitus is the perception of sound when no external noise is present. It may be temporary or ongoing. Perceived sounds may be ringing, hissing, static, crickets, screeching, whooshing, roaring, pulsing, ocean waves, buzzing, dial tones, or music.
The American Tinnitus Association has playlist of the most common tinnitus sounds.
Symptoms depend upon the type of tinnitus. The following descriptions are from the American Tinnitus Association.
When chemotherapy causes hearing loss, it is usually because the drug has been absorbed into the fluid that surrounds hair cells.
It keeps the hair cells from working properly. They cannot send signals to the brain, making it harder to hear certain sounds.
High doses of radiation (30 Gy or higher) to the head or brain.
It can cause damage to the:
Surgery involving the brain, ear, or auditory (eighth cranial) nerve may have an impact on hearing.
Other conditions that are not caused by cancer and its treatment may lead to hearing loss in survivors. These may include:
Ask your oncologist about your risks of developing late effects.
Inform your primary health care provider about your risks. Share a copy of your Survivorship Care Plan, which includes a treatment summary. The summary includes details about your cancer treatment and information about health problems that may occur because of treatment.
Tell your provider if you have experienced any difficulties hearing or if you are hearing sounds such as ringing or buzzing that are not caused by an outside source.
Everyone who has had cancer treatment that can affect hearing should have their hearing tested:
Survivors who are 3 or older should be screened with a pure tone audiogram (hearing screening test.)
During an audiogram, the person wears earphones and listens for sounds of different pitches and degrees of loudness.
People who are not able to have an audiogram (such as those who are too young or who cannot understand the test instructions) can have their hearing tested using Auditory Brainstem Response (ABR). The person having this test is usually given medicine so they can go to sleep, and then their brainwave responses to various sounds are recorded.
Additional tests may be necessary. These may include speech audiometry and tympanometry tests.
When a hearing problem is suspected, survivors are encouraged to have a consultation with an audiologist or otologist.
Patients with hearing problems should have ongoing follow-up.
Speech and language therapy for patients with hearing loss may be necessary.
Survivors with hearing loss who are students in K-12, college, or trade schools are encouraged to contact an academic coordinator or school liaison at their treatment center. The coordinator can help work with the school and advocate for the student’s educational needs.
The academic coordinator can:
After high school, survivors are responsible for arranging services on their own. College and trade school students are encouraged to contact their school’s student disability office. The Americans with Disabilities Act requires postsecondary schools and programs that receive federal funding to make programs accessible to qualified students with disabilities.
Students can start working with these offices after they are accepted to the institution. A parent and/or academic coordinator can help request services and advocate for accommodations.
Students may also need to talk with each instructor about their medical history and what they need in each classroom. It is important that survivors are knowledgeable about their needs.
If you have or are at risk for hearing loss, be sure to seek treatment right away if you have an ear infection, swimmer’s ear, or earwax blockage. Also, take care to protect your ears from loud noises, which can damage your ears.
Examples of items, activities, and jobs that can increase risk for hearing loss include:
If you can’t avoid exposure to loud noise, you should:
Reviewed: December 2019