# Association Between Sensorineural Hearing Loss and Neurocognitive Performance in Survivors of Childhood Cancer: A Systematic Review and Meta‐Analysis

## TL;DR

Childhood cancer survivors with severe hearing loss show significant cognitive deficits compared to those without, suggesting the need for routine hearing and cognitive assessments.

## Contribution

This study provides the first meta-analysis quantifying the neurocognitive impact of severe sensorineural hearing loss in childhood cancer survivors.

## Key findings

- Survivors with severe SNHL scored significantly lower in overall intellectual functioning and verbal reasoning.
- Deficits were also observed in perceptual reasoning, working memory, processing speed, and reading abilities.
- The study emphasizes the importance of early screening and intervention for neurocognitive impairments in this population.

## Abstract

Various studies have shown that sensorineural hearing loss (SNHL) is associated with neurocognitive impairment among childhood cancer survivors, though prior studies are limited by small sample sizes and inconsistent methods.

This systematic review and meta‐analysis aimed to quantify neurocognitive differences between survivors with severe SNHL (s‐SNHL) and those without.

Studies were included if they evaluated childhood cancer survivors (diagnosed ≤ 21 years), were ≥ 2 years posttreatment, received cranial radiation and/or platinum‐based chemotherapy, used validated neurocognitive tests, and included survivors with and without SNHL. Methods and reporting adhered to the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines. Databases searched included PubMed, Web of Science, Cochrane, Scopus, PsycINFO, and Embase. Study quality was assessed using an adapted version of the Newcastle–Ottawa Scale. We collected study details, including authors, year, neurocognitive tests used, sample sizes, and group scores (means and standard deviations [SD]). Pooled mean differences (MD) and 95% confidence intervals (95% CI) were calculated using standard scores (mean = 100, SD = 15) and random‐effects models.

Of 1012 records identified, nine studies were included in the analyses, with 503 childhood cancer survivors with s‐SNHL and 1553 survivors without s‐SNHL. Compared to survivors without s‐SNHL, survivors with s‐SNHL scored lower on measures of overall intellectual functioning (MD = −8.1, 95% CI = −10.0, −6.2), verbal reasoning (MD = −9.7, 95% CI = −11.4, −7.9), perceptual reasoning (MD = −6.6, 95% CI = −11.1, −2.1), working memory (MD = −5.3, 95% CI = −7.1, −3.4), processing speed (MD = −6.3, 95% CI = −9.9, −2.6), short‐term visual memory (MD = −6.0, 95% CI = −8.2, −3.7), and reading (MD = −6.2, 95% CI = −7.9, −4.5).

Severe SNHL is associated with significant neurocognitive deficits in childhood cancer survivors. Routine hearing screening and timely neurocognitive assessments are recommended to identify and address these impairments.

PROSPERO: CRD42023440952

This systematic review and meta‐analysis found that childhood cancer survivors with severe sensorineural hearing loss (s‐SNHL) had significantly lower scores in various neurocognitive domains, including IQ, memory, and processing speed, compared to survivors without s‐SNHL. The findings highlight the importance of neuropsychological assessments for those with s‐SNHL to identify and address potential deficits in childhood cancer survivors.