Hearing

Hearing is a fundamental sensory input required for language acquisition and social interaction. Radiotherapy fields that involve the cochlea are associated with hearing loss at dosages over 30 Gy. Cisplatin is known to cause hearing loss in a high percentage of patients, especially when dosages exceed 300 mg/m². Radiotherapy to the cochlea and cisplatin administration combine to produce hearing loss in most patients. Children with medulloblastoma are at high risk of developing hearing loss due to these factors. Proton beam radiotherapy offers the possibility of minimizing cochlear radiation dose and might help to prevent hearing loss. Predisposing factors, pathophysiology, clinical features, and consequences of hearing loss in the pediatric brain tumor population are discussed. Brief mention is made of therapeutic interventions, prevention, and radiotherapy dose tolerances for this select group of patients.