Ototoxicity is damage to the inner ear, hearing nerve and vestibular or balance system that develops as a side effect of taking certain medications. It can cause problems related to hearing, balance, and functions that your inner ear controls. It may be helpful to think of ototoxicity’s effects in terms of the word’s origins:
Some medicines used to treat infections and cancer, among other conditions, can damage the sensory cells inside the inner ear that help you hear and keep your balance.
The exact mechanism that causes this damage is not fully understood, however, the effect has been recognized since the 1800s. This damage can be reversible and temporary, or irreversible and permanent. Many well-known ototoxic drugs are prescribed in critical health situations, such as kidney failure, despite the risk of hearing loss.
Ototoxic drugs include the following: antibiotics such a gentamicin, streptomycin, tobramycin, loop diuretics such as furosemide and platinum-based chemotherapy agents such as cisplatin and carboplatin. Some nonsteroidal anti-inflammatory drugs (NSAIDS) have also been shown to be ototoxic.
Additionally, some environmental and occupational chemicals have been shown to affect the auditory system and may be exacerbated when combined with noise exposure. Make sure to read the warning labels thoroughly before working with the following products and wear a safety mask, protective clothing, and goggles when appropriate: pesticides, solvents, asphyxiants and heavy metals such as mercury and lead. The results of exposure to these can be sensorineural hearing loss, balance issues, or both.
Symptoms of an ototoxic reaction may be:
When a person is prescribed any of the classes of drugs mentioned above, a physician may suggest or recommend that their hearing to be monitored by a licensed hearing care professional throughout treatment. A hearing test administered prior to starting an ototoxic medication can be used as a baseline against which to compare future tests to determine if any change in hearing has occurred. Daily or regular hearing testing may be recommended to monitor any decrease in your hearing abilities while taking the medication. Testing of the balance system (vestibular testing) may also be used to assess any effects on balance. Speak with your physician to better understand if your medication has any known risks to hearing health and steps to take.
As these types of drugs or medications are prescribed in critical health situations, their use is balanced between the treatment of the underlying disease and the damage to hearing.
While there is no way to reverse damage once it happens, providers can monitor your condition so that they can provide treatments and support if you are experiencing symptoms.
If permanent hearing damage is detected, treatment options include hearing aids, hearing assistive technology and cochlear implants to improve communication. To find an audiologist near you to ask questions or have your hearing tested, please visit https://www.hearing.org/find-a-hearing-professional/
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