What Is Ototoxicity?
Ototoxicity is a medical term that translates literally to ear poisoning. It is caused by exposure to certain medications and results in hearing loss, balance problems, or tinnitus, more commonly known as ringing in the ears. Ototoxicity is classified as a sensorineural type of hearing loss, which means that it occurs in the inner ear.
What Causes Ototoxicity?
Both medications and some environmental toxins can cause ototoxicity. Some of the most common drugs and toxins are listed below, however there may be others to consider. This is why it is important to discuss any new medications and their potential side effects with your healthcare provider.
- NSAIDs– Non-steroidal Anti-inflammatory drugs (NSAIDs) have known side effects of ototoxicity. Commonly used medications such as ibuprofen for pain or aspirin are included on this list. Because some ibuprofens, such as Motrin or Advil, are over the counter medications, it is even more important to understand the side effects and only dose these medications as directed. Aspirin, in higher doses, can cause tinnitus. Tinnitus is the medical term for ringing in the ears.
- Loop Diuretics– Loop diuretics sometimes known as “water pills” to patients, are called this because they work to rid the body of excess fluid. Some common loop diuretics are furosemide, or Lasix, and etacrynic acid, or Edecrin. These types of medications are considered more ototoxic depending on the dosage and the rate the medication is given.
- Antibiotics- Not all antibiotics have ototoxicity as a side effect. However antibiotics in the aminoglycoside class, such as gentamicin, tobramycin, and neomycin, are known ototoxins.
- Chemotherapeutic agents– Broadly speaking, chemotherapy works to kill cells without always being able to differentiate the good versus the bad cells. Because of this, some chemotherapy drugs are considered ototoxic. Cisplatin and carboplatin are both known to cause hearing loss.
- Environmental toxins– Several environmental factors are known to cause hearing issues or tinnitus. Certain types of professions are more exposed to these toxins and should be aware, such as painting, construction, firefighting, and anyone who works with pesticides. Just a few of these ototoxins are listed below.
- Carbon monoxide
Signs and Symptoms
Ototoxicity can present itself in three primary ways and it can occur in one or both ears.
- Hearing Loss– Gradual or sudden hearing loss can occur with exposure to these ototoxins. It can be present in one or both ears and can present itself at different degrees of hearing loss ranging from mild to profound hearing loss.
- Balance problems– The inner ear’s anatomy regulates the body’s ability to keep balance. When the inner ear’s baseline is altered with ototoxins, balance issues and dizziness can occur.
- Tinnitus– As mentioned, tinnitus is the medical term for ringing in the ears. It is a common symptom of ototoxic medications and can accompany possible hearing loss.
Prevention and Treatment
Prevention for ototoxicity involves awareness and education. When starting a new medication, make sure to review potential side effects with your healthcare provider as well as what to do if you do experience these side effects.
If you work in an environment with potential workplace hazards, know the personal protection equipment, or PPE, that should be used. Understanding how to put on and take off, or don and doff, this equipment is an important step to minimizing exposure and risk.
If you being to experience any of the ototoxic symptoms such as hearing loss, balance issues, or tinnitus, you should see your healthcare or hearing health provider right away to report your symptoms. These symptoms are sometimes reversible with either the reduction of dosage or ceasing the medication all together.
However, if the symptoms cannot be reversed there are a number of treatment options available, the most common is hearing aids. When speaking to your hearing health provider they will review your symptoms and likely perform a hearing test to determine the best course of action. If hearing aids are the preferred treatment, they will be fitted physically to your ears and programmed specifically for your hearing loss.
Ultimately, education and awareness is key to understanding your ototoxicity risk as well as management. Speak with your provider for more information about the medications you are taking as well as any potential workplace hazards.