Aim: Hearing impairment in transfusion dependent thalassemia patients (TDT) has been variably attributed to iron chelation therapy. This study aimed to evaluate auditory function in TDT children and adolescents and compare them to healthy control.
Methods: This case-control study included 30 TDT children who were on deferasirox/ deferoxamine chelation therapy and 30 age- and sex-matched healthy controls. The auditory evaluation performed included pure tone audiometry (PTA), tympanometry, and speech audiometry.
Results: The comparison of PTA thresholds between TDT patients and healthy controls revealed no statistically significant differences across all tested frequencies for both ears (p>0.05). The comparison of tympanometry measurements also revealed no statistically significant differences across all measured pressure points for both right and left ears. All participants demonstrated normal hearing sensitivity (≤15 dB hearing level) with type A tympanometric patterns and none exhibited signs of suspected sensorineural hearing loss based on the combination of Pure tone audiometry and discrimination score results. The PTA thresholds also demonstrated patterns of negative correlation with MRI results of T2* and positive correlation with LIC at lower and higher frequencies in both ears.

Conclusions: The findings of this study indicate that children and adolescents with transfusion-dependent β-thalassemia demonstrate preserved auditory function across all standard audiological parameters. The absence of overt hearing loss should therefore not be interpreted as the absence of risk; instead, it reflects a delicate balance maintained by current transfusion and chelation practices.