Retinoblastoma: An Update on Clinical, Genetic Counseling, Epidemiology and Molecular Tumor Biology
Chemotherapy is often used in the conservative management of retinoblastoma. Chemotherapy drugs, while ameliorative, can produce long-lasting side effects that potentially can affect survivor quality of life. Carboplatin is a common chemotherapy agent with known ototoxic side effects that is used in the treatment of retinoblastoma (Rodriguez-Galindo et al., 2003). The potential for carboplatin-induced hearing loss is of concern to the medical professional, given that retinoblastoma is often diagnosed in early childhood and children with retinoblastoma have visual impairments. This chapter will outline the mechanisms underlying carboplatin ototoxicity. The extent of knowledge concerning the pathophysiology of carboplatin-induced hearing loss will be explained, and descriptions of the progression of hearing loss on the audiogram will be provided. The types of hearing tests administered to patients receiving carboplatin chemotherapy and monitoring regimens will be reviewed in the chapter. Physiological hearing tests, including the auditory brainstem response (ABR) and otoacoustic emissions (OAE) will be described. Knowledge of these tests will assist the medical professional in understanding if a particular chemotherapy regimen is potentially causing a hearing loss.The impact of high-frequency hearing loss on the development of speech and language in young children will be discussed, which is of particular relevance in children with an existing visual loss. In the context of this discussion, the academic and social development of children with hearing loss will be addressed. Future directions, including the potential use of otoprotective agents that can be given concurrently with chemotherapy treatment, will be highlighted at the end of the chapter.
Shaum P. Bhagat (2012). Ototoxic Hearing Loss and Retinoblastoma Patients. Retinoblastoma: An Update on Clinical, Genetic Counseling, Epidemiology and Molecular Tumor Biology. Prof. Govindasamy Kumaramanickavel (Ed.), InTech, DOI: 10.5772/31683.