Ototoxicity

Hearing damage from medications and chemicals

Overview

Ototoxicity is damage to the cochlea, the vestibular system, or the auditory nerve caused by medications or chemicals. Well known ototoxic drugs include aminoglycoside antibiotics such as gentamicin, platinum based chemotherapy agents such as cisplatin, loop diuretics, and high dose salicylates such as aspirin. Aminoglycosides and cisplatin typically cause permanent loss of outer hair cells starting at high frequencies, while hearing changes from salicylates and loop diuretics are often reversible. Aminoglycosides can also damage the vestibular system, causing bilateral vestibulopathy. Audiological monitoring during treatment with known ototoxic drugs is used to detect changes early. A mitochondrial variant, m.1555A to G in the MT-RNR1 gene, makes carriers highly susceptible to aminoglycoside induced deafness, and genetic testing for it is used in some settings. Industrial solvents such as toluene and styrene and some heavy metals are also ototoxic and can interact with noise exposure to increase damage.