Ototoxicity

Ototoxicity
Synonyms
Pronounce	N/A
Specialty	N/A
Symptoms	Hearing loss, tinnitus, dizziness, balance disorders
Complications	Permanent hearing loss, vestibular dysfunction
Onset
Duration
Types	N/A
Causes	Medications, chemicals, infections
Risks	High doses of aminoglycosides, chemotherapy agents, loop diuretics
Diagnosis	Audiometry, vestibular testing
Differential diagnosis	Presbycusis, Meniere's disease, acoustic neuroma
Prevention	Monitoring drug levels, using alternative medications
Treatment	Discontinuation of the offending agent, hearing aids, cochlear implants
Medication	N/A
Prognosis	Variable, depending on the extent of damage
Frequency
Deaths	N/A

Ototoxicity refers to the property of being toxic to the ear (oto-), specifically the cochlea or auditory nerve and sometimes the vestibular system; it is commonly medication-induced. Ototoxicity can result in temporary or permanent disturbances in hearing, balance, or both.

Causes

Ototoxicity is often caused by certain medications and chemicals that damage the inner ear. Common ototoxic drugs include:

• Aminoglycoside antibiotics (e.g., gentamicin, amikacin)
• Chemotherapy agents (e.g., cisplatin, carboplatin)
• Loop diuretics (e.g., furosemide, bumetanide)
• Nonsteroidal anti-inflammatory drugs (NSAIDs) (e.g., aspirin, ibuprofen)

Symptoms

The symptoms of ototoxicity can vary depending on the affected part of the ear. Common symptoms include:

• Tinnitus (ringing in the ears)
• Hearing loss
• Vertigo (a sensation of spinning)
• Balance disorders

Diagnosis

Diagnosis of ototoxicity typically involves:

• Audiometry to assess hearing function
• Vestibular testing to evaluate balance function
• Detailed patient history to identify potential ototoxic agents

Prevention and Management

Preventing ototoxicity involves careful monitoring of drug levels and minimizing exposure to known ototoxic agents. Management strategies include:

• Discontinuation or substitution of the ototoxic drug
• Use of protective agents (e.g., amifostine for cisplatin-induced ototoxicity)
• Rehabilitation therapies such as hearing aids or cochlear implants for hearing loss

Related Pages

• Hearing loss
• Tinnitus
• Vertigo
• Audiometry
• Vestibular system
• Cochlea
• Auditory nerve

See Also

• Ototoxic drug
• Inner ear
• Balance disorder