Episode # 3 • 17 Jan 2025
Hearing Loss & Aural Rehab in Children with Cancer
After months of chemotherapy, some children arrive in the clinic depressed and unable to hear their families, and after a cochlear implant, as Dr. Daniela Carvalho puts it, “you see a smile on their face again.” On this episode of the BackTable Creator Weekend™ series on pediatric head and neck cancer, host Dr. Anthony Sheyn welcomes pediatric otolaryngologist Dr. Daniela Carvalho and audiologist Dr. Julie Silva to discuss hearing loss and aural rehabilitation in children with cancer. They cover baseline and surveillance testing during ototoxic chemotherapy, how cisplatin, carboplatin, and cranial radiation shape the monitoring schedule, where sodium thiosulfate fits, and how extended high-frequency testing and otoacoustic emissions can catch changes before the standard audiogram does.
Timestamps
00:00 - Introduction
02:47 - Baseline Testing and Surveillance Protocols
05:14 - Hearing Preservation During Treatment and Sodium Thiosulfate
07:34 - The Case for an Audiology Tumor Board
09:52 - Extended High-Frequency Testing and ABR Under Anesthesia
13:21 - Ear Tubes and Eustachian Tube Dilation After Radiation
16:07 - Cochlear Implants and MRI Surveillance
18:14 - Rehabilitation Options Without a Cochlear Implant
20:20 - Long-Term Impact, Follow-Up, and Awareness
24:36 - Tinnitus, Mental Health, and Vestibular Care
27:27 - Cochlear Implant Outcomes and Closing Remarks
Resources
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More about this episode
The discussion then moves through timing auditory brainstem response testing with procedures that already require anesthesia, ear tubes and eustachian tube dilation for radiation-related middle ear disease, and the trade-off between a cochlear implant and the MRI surveillance a child with a brain tumor still needs. Dr. Carvalho and Dr. Silva describe options for children who cannot yet be implanted, from hearing aids and sign language to CROS and bone conduction devices, and discuss tinnitus, mental health support, and follow-up into adulthood. Along the way, all three make the case for an audiology tumor board.
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