Type 2 diabetic patients had significantly higher incidence for at least the mild degree of HL when compared with controls. Mean PTA thresholds were greater in diabetics for all frequencies but were more clinically relevant at 6000 and 8000 Hz. Prolonged ABR wave V latencies in the diabetic group suggest retro-cochlear involvement. Age and duration of DM play important roles in the occurrence of DM-related HL.

High quality literature in the topic is lacking. Radiation-induced SNHL is progressive, permanent, and dose-dependent. Total dose and follow-up time are important factors affecting incidence rates.

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Metformin is not ototoxic or radioprotective in vitro or in vivo. Ears solely subjected to metformin had better hearing thresholds than the rest of the groups.

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A daily dose of caffeine was found to impair the recovery of hearing after an AOSE.