What is Ototoxicity?

Simply put, ototoxicity is poisoning of the ear (oto = ear; toxicity = poisoning). Ototoxicity is a result of exposure to chemicals or drugs that damage the inner ear (cochlea) or the vestibulo-cochlear nerve (the nerve that sends hearing and balance information to the brain). It usually occurs as a side effect of a drug. Ototoxic damage causing hearing loss is generally irreversible.

Which drugs can cause Ototoxicity?

There are several drugs that can cause ototoxicity. Usually they are prescribed, despite the possibility of damaging a patient’s hearing, to very serious health conditions. These drugs include antibiotics such as gentamycin, loop diuretics such as furosemide and platinum-based chemotherapy agents such as cisplatin. There are also a number of nonsteroidal anti-inflammatory drugs (NSAIDS) that have shown to be ototoxic.

Signs and symptoms of Ototoxicity:

Ototoxicity typically occurs when the inner ear is poisoned by medication which damages the cochlea, the vestibule, semi-circular canals, or the auditory nerve. As a result of damage to one or more of these structures, a patient may experience hearing loss, disequilibrium or vertigo, and tinnitus. A patient may also experience any of the following:

  • A higher risk of falls due to balance issues
  • A loss of hearing has been linked to cognitive decline and risk of dementia.
  • Psychological effects, such as depression, isolation, anxiety, anger, self-esteem issues
  • Broader economic impacts, such as a higher rate of unemployment, difficulty in attaining employment and advancing a career

Treatment:

No specific medical treatment is generally available, however withdrawal of the ototoxic medication may be advised when the risks of doing so are less severe than the hearing loss or associated symptoms caused by ototoxicity (meaning if the person is healthy enough to be taken off the medication, they will be).

Hearing aids, however, may be a successful option in treating a hearing loss caused by ototoxicity, and it is worth consulting with an audiologist about the best form of treatment in this regard.