الفهرس 
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Abstract
Leukaemia is defined as clonal proliferation and arrest at a particular phase of normal myeloid or lymphoid hematopoiesis and acute leukemias (AL) account for 97% of all leukemias in children.
The most common malignant tumor in childhood and teens is leukemia, representing almost one-third of cancers in this population. About 75% of AL among children and adolescents are ALL.
With the increase in survival rate, using cancer treatment at an early years of life can cause side effects that may not become obvious until later age.
Late sequelae in pediatric survivors of cancer, eg,. growth and development alterations as well as, neurocognitive problems.
Hearing loss as a long term problem of the treatment of pediatric cancer has been reported and is essentially related to ototoxic chemotherapy and head &neck irradiation.
Childhood ALL therapy lacks the commonly chemo-therapy drugs causing ototoxicity and seldomly head & neck irradiation used, but most cases developed febrile neutropenia that treated with empirical antibiotics, like aminoglycosides.
The aim of the study:
The study aimed to assess the hearing status of 55 survivors of children of acute lymphoblastic leukemia aging from 4-18 years who completed their chemotherapy at the Pediatric Hematology and Oncology Unit of Alexandria University Children’s Hospital and to be compared with 55 healthy age and sex-matched as a control group with the exclusion of those who had history of otological diseases such as drum perforation and auricular anomalies, hereditary hearing loss and those treated for AML.
Methods
Assessment of hearing function in children was done through pure tone audiometry (the gold standard of hearing sensitivity; it utilized frequency specific pure tones to give place specific responses), middle ear pressure and speech audiometry.
During evaluation of hearing function in a child, careful history taking (family history, ototoxic drugs use, NICU admission, previous infections, history of systemic diseases, irradiation exposure and history of trauma).
Audiogram results in the current study showed that 89% (98 ears) were normal, bilateral hearing loss was detected in 5(10 ears) cases, right ear conductive hearing loss =5 ears, and left ear conductive hearing loss =6 ears, and only one patient had sensorineural hearing loss.
The comparison of middle ear pressure between patients and control groups revealed that in the patients’ group type A was 81 ears (82.7%), type As was 2 ears (2%), type c was 4 ears (4.1%), type B was 9 ears (9.2%) and perforated type was 2 ears (2%), whereas, in the control group type A was 107 ears (97.3%), type C was 3 (2.7%) ears, the other types of middle ear pressure were missing, the result was statistically significant (p=<0.001).