Ototoxicity Associated with Antineoplastic Agents in the Pediatric Population: An Evidence-Based Review of Auditory Monitoring Strategies and Contemporary Diagnostic Frameworks-Narrative Review

Ototoxicity represents a clinically significant complication of anticancer therapy in pediatric patients. Cytotoxic agents used in oncology, particularly platinum-based chemotherapy, may induce damage to the auditory and vestibular systems, resulting in hearing loss, tinnitus, and balance disturbances....

✦ Clinical Takeaway ✦

Audiologists managing pediatric oncology patients should apply evidence-based auditory monitoring protocols aligned with current diagnostic frameworks for platinum-based chemotherapy ototoxicity; this review consolidates existing guidance but does not introduce new practice-changing evidence.

✦ Why It Matters ✦

Pediatric ototoxicity monitoring is an underserved area where standardised protocols can meaningfully reduce permanent hearing loss in childhood cancer survivors.

✦ Key Points ✦

01Platinum-based chemotherapy (e.g., cisplatin, carboplatin) is a leading cause of permanent hearing loss in pediatric oncology patients.
02The review evaluates current auditory monitoring strategies including high-frequency audiometry and OAE testing.
03Contemporary diagnostic frameworks such as SIOP and ASHA grading scales are compared.
04Early detection through serial audiological monitoring is emphasised to enable timely intervention.
05Gaps in standardisation of monitoring schedules across institutions are identified.

✦ Claims & Evidence ✦

ClaimEvidenceSupport

Platinum-based chemotherapy causes ototoxicity (hearing damage) in pediatric oncology patients.

studysupported

Evidence-based auditory monitoring strategies can facilitate early detection of chemotherapy-induced hearing loss in children.

guidelinesupported

✦ Research metadata ✦

PMID: 42121973
DOI: 10.3390/diagnostics16091272.
Journal: Diagnostics
Publication type: review
Evidence level: 5
Population: Pediatric oncology patients receiving antineoplastic (cancer-fighting) agents, particularly platinum-based chemotherapy
Intervention: Auditory monitoring strategies and diagnostic frameworks for ototoxicity surveillance

Primary outcomes

Evaluation of auditory monitoring strategies for ototoxicity detection; Comparison of contemporary diagnostic frameworks for hearing loss classification

✦ Related stories ✦

PubMed·Journal article·Pediatric·2w ago

Early Auditory Stimulation, Not Device Type: Comparable Cortical Maturation in Children Using Cochlear Implants or Hearing Aids

Prioritise early auditory stimulation regardless of device type — timing of intervention appears more important than the choice between cochlear implant and hearing aid for cortical auditory maturation.

PubMed·Journal article·Pediatric·9d ago

Quantifying Inner Ear Function in Children With a Diagnosis of Cancer: Assessment of Vestibular and Audiometric Function

Audiologists and oncology teams caring for pediatric cancer patients should routinely screen for vestibular impairment alongside audiometric monitoring, as this study suggests vestibular damage is an under-detected late effect of cancer treatment in children.

PubMed·Journal article·Pediatric·3w ago

Newborn hearing screening in infants at risk of hearing loss: diagnostic outcomes, false-negative results, and the role of surveillance

Clinicians managing at-risk newborns should maintain structured audiological surveillance beyond initial screening, as false-negative rates indicate that a single screen is insufficient for this population.

PubMed·Journal article·Pediatric·6d ago

When hearing loss mimics autism: Enlarged vestibular aqueduct syndrome in an 11-year-old child-A case report

Clinicians should consider audiological evaluation, including imaging for structural inner-ear abnormalities like enlarged vestibular aqueduct, before or alongside autism spectrum disorder workups in children with social communication deficits.

PubMed·Journal article·Pediatric·6d ago

Status and gaps in newborn hearing screening in South Africa: A cross-sectoral review

No single new clinical action is indicated, but audiologists and programme administrators involved in newborn hearing screening in South Africa (or comparable settings) should use these identified gaps as a checklist for local programme audits.

PubMed·Journal article·Pediatric·2w ago

Exploring and Overcoming Challenges for Efficient Audiological Testing in Children Under 5 Years of Age-Screening with Otoacoustic Emissions

Audiologists monitoring pediatric oncology patients on cisplatin should consider OAE screening protocols adapted to the practical challenges of testing children under 5, though specific protocol changes depend on the study's detailed findings and local resources.

PubMed·Journal article·Pediatric·6d ago

Newborn and infant hearing screening outcomes at a tertiary paediatric hospital in the Western Cape, South Africa

The findings confirm systemic implementation failures in newborn hearing screening at this site; audiologists and programme managers in similar low-resource settings should audit their own screening uptake and follow-up rates against national EHDI benchmarks.

PubMed·Journal article·Pediatric·1d ago

A multidisciplinary, symptom-targeted approach to rehabilitation in pediatric concussion

Audiologists and vestibular rehabilitation specialists treating pediatric post-concussion patients should consider participating in or referring to multidisciplinary teams that use symptom-targeted protocols, particularly for vestibular symptoms.