Version May 2024
| Hearing loss |
| General recommendation |
| Survivors treated with cisplatin, with or without high-dose carboplatin (>1500 mg/m2), or head or brain radiotherapy ≥30 Gy and their health care providers should be aware of the risk of hearing loss |
| Who needs surveillance and how often should surveillance be performed? |
| Surveillance for hearing loss is recommended for survivors treated with cisplatin, with or without high-dose carboplatin (>1500 mg/m2), or head or brain radiotherapy ≥30 Gy to begin no later than the end of treatment and to be done annually for children younger than 6 years of age, every other year for children 6 to 12 years of age, and every 5 years for adolescents and young adults older than 12 years of age |
| Hearing loss surveillance might be reasonable for survivors who had placement of CSF shunts to begin no later than the end of treatment and be repeated every 5 years thereafter |
| What surveillance modality should be used? |
| Pure tone conventional audiometry testing is recommended for survivors ≥6 years of age at 1000 to 8000 Hz, and additional testing with high-frequency audiometry at >8000 Hz is recommended whenever equipment is available; referral to an audiologist for more extensive testing is recommended for survivors <6 years of age |
| What should be done when atypical measurements are identified? |
| Referral to an audiologist or auditory clinic is recommended for any survivor who has symptoms suggesting hearing loss or atypical audiological test results showing a loss of more than 15 dB absolute threshold level (1000 to 8000 Hz) |
| Tinnitus |
| General recommendation |
| Survivors treated with cisplatin, with or without high-dose carboplatin (>1500 mg/m2), or head or brain radiotherapy ≥30 Gy and their health care providers should be aware of the risk of tinnitus. Referral to an audiologist is recommended for survivors who have symptoms of tinnitus |
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