157 - Vestibular and Auditory Ototoxicity

Abstract

This chapter provides information dealing with the most common drugs that are associated with ototoxicity and sensorineural hearing loss because of radiation therapy. The drugs most frequently associated with permanent and significant sensorineural hearing loss are the aminoglycoside antibiotics and platinum chemotherapeutic drugs. Difluoromethylornithine-induced hearing loss is almost always reversible. Hearing loss from loop diuretics such as furosemide and ethacrynic acid may be temporary or, in rare cases, permanent. Hydrocodone in therapeutic doses does not appear to cause hearing loss. However, when it is abused and taken in very high doses for prolonged periods of time, severe hearing loss can result. Methadone abuse has been associated with transient hearing loss, but a few cases of permanent deafness have been reported. Salicylates typically cause tinnitus and temporary hearing loss. Quinine and related drugs can cause tinnitus and hearing loss. Erythromycin and deferoxamine can cause significant hearing loss. Vancomycin appears to be ototoxic when combined with other ototoxic drugs such as aminoglycoside antibiotics. Radiation to the brain or head and neck area has been associated with significant sensorineural hearing loss. Mechanisms and risk factors for these ototoxic agents are discussed in this chapter.