Chemotherapy and Hearing Loss

It has long been known that the chemotherapy drugs and radiation needed for the treatment of cancer can damage one’s hearing. And, hearing loss interferes with one’s daily living. If these therapies were received, it is important to have your hearing checked and obtain treatment if hearing loss is found.

Hearing loss that occurs in the outer or middle ear is called a conductive hearing loss. This means that the hearing loss is due to a problem in transmission of sound from the air to the inner ear. An example of this would be changes in hearing because of fluid collection in the middle ear. Sometimes this happens when people have ear infections. The fluid “muffles” the sound when it is traveling through the middle ear.

Hearing loss that results from damage to the inner ear or auditory nerve is called sensorineural hearing loss. An example of this would be damage to the sensory hair cells in the inner ear from chemotherapy. Even though sound waves still move through the inner ear fluid, they can no longer be changed into nerve impulses, so the sound does not reach the brain. Sensory hair cells that process high-pitched sounds are usually damaged first, followed by damage to the sensory hair cells that process lower-pitched sounds.

Hearing loss with both conductive and sensorineural components is called mixed hearing loss.

The following cancer treatments can potentially cause hearing loss:

Chemotherapy from the “platinum” group, such as cisplatin or high doses of carboplatin
High doses of radiation to the head or brain
Surgery involving the brain, ear or auditory nerve
Certain antibiotics and diuretics used in association with cancer treatment

High doses of radiation to the ear or brain can cause inflammation or ear wax buildup in the outer ear, problems with fluid buildup in the middle ear, or stiffness of the eardrum or middle ear bones. Any of these problems can result in conductive hearing loss. Radiation can also damage the sensory hair cells in the inner ear, causing sensorineural hearing loss.

Damage from radiation may affect one or both ears, depending on the area of treatment. Conductive hearing loss may improve over time, but sensorineural hearing loss is permanent. Platinum chemotherapy can cause damage to sensory hair cells in the inner ear, resulting in sensorineural hearing loss. Most often, the effect is similar in both ears and is permanent.

Patients that have had cancer treatment, should have their hearing tested by a doctor of audiology at least once following completion of treatment. It is best though, to have an audiogram before and after treatment to monitor any hearing loss. If hearing loss is found, an audiologist will determine the need for additional testing.

Vanessa Ewert, AuD of Bluegrass Hearing Clinic states, “Post-chemotherapy quality of life is too important for cancer patients. Hearing loss can cause problems with a person’s ability to communicate therefore affecting daily activities. It is our job to assist them in finding the technology and services that best help them to communicate in order to live their best life.”