[Neurosensory, aesthetic and dental late effects of childhood cancer therapy]. / Séquelles sensorielles, esthétiques et dentaires après traitement pour un cancer dans l'enfance.

ABSTRACT

Oncologic management in pediatric patient may be associated with a high risk of neurosensory deficit, such as taste, olfaction, vision and hearing. These neurosensory deficits can be linked to chemotherapy toxicity or to a direct deleterious effect of local radiotherapy or surgical management in case of craniofacial cancers. Neurosensory deficit may be temporary but are usually irreversible and frequently progress after the completion of treatment. Taste and olfaction deficits expose to high risk of nutritional complications and quality of life alteration. Hyposialia, as a result of irradiation of the salivary glands, increases taste changes and the risk of dental caries. The risk of cataract is present in patients who received high dose corticosteroids and/or brain or orbital irradiation. When hearing is affected, a risk of impaired intellectual or academic performance is increased with an impact on the quality of life in absence of specific care. Finally, there are some cosmetic consequences of therapy such as alopecia and scarring that alter the image of the patient. Early detection of these problems in order to limit medical, psychological, educational and social impact is mandatory. Moreover, high risk of worsening of these deficits after completion of therapy support long-term follow-up children treated for cancer, especially with head and neck primary.