Instability Due to Drug-Induced Vestibulotoxicity

Sánchez-Sellero, Inés; Soto-Varela, Andrés

doi:10.5152/iao.2016.2242

Cited by 8 publications

(5 citation statements)

References 19 publications

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“…A study examining the role of EHF in ototoxicity monitoring demonstrated that among the 45 patients affected by ototoxicity, hearing loss was unilateral in 31.1% (n = 14) before bilateral hearing loss was reported. 36 Similar to hearing threshold changes, the VHIT results in the current study showed that left ears were significantly more affected than right ears. Vestibulotoxicity may well follow a similar trajectory because of the shared blood, nerve and fluid sources.…”

Section: Discussionsupporting

confidence: 71%

Changes in vestibular and cochlear function following platinum-based chemotherapy: A preliminary report

et al. 2022

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Objectives This study investigated the changes in vestibular and cochlear function in patients receiving platinum-based chemotherapy. Methods A longitudinal study of 32 participants (10-70 years) receiving chemotherapy participated in the study. Baseline and exit vestibular and hearing assessments that included video head impulse (VHIT) testing, cervical and ocular vestibular evoked myogenic potentials (VEMP), dynamic visual acuity (DVA) and pure-tone audiometry were performed at the patient’s treatment venue. Results Half (50%) of the participants showed cochleotoxicity from baseline to exit testing, with left ears significantly more affected than right ears. There was no consistent relationship between hearing loss and vestibular dysfunction. DVA yielded normal results at baseline and exit testing in all participants. VEMP responses were absent in 28.1% of participants at baseline, reflecting the challenges of using VEMP for monitoring. VEMP and VHIT results showed a statistically significant ( p < 0.05) decline in results from baseline to exit testing; however, participants did not report symptoms related to vestibular dysfunction. VHIT also showed left ears significantly ( p < 0.05) more affected than right ears. Conclusion VHIT proved to be a valuable measure of changes in vestibular function secondary to ototoxicity. Future investigations should determine vestibulotoxicity criteria and optimal protocols for vestibulotoxicity monitoring at the patient’s treatment venue.

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Section: Discussionsupporting

confidence: 71%

Changes in vestibular and cochlear function following platinum-based chemotherapy: A preliminary report

et al. 2022

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“…Participants found the additional one-leg stance and one-leg squat balance tests challenging to perform especially when vision was removed. Sanchez-Sellero and Soto-Valera (2016) found an association between three anti-TB therapy drugs and the development of vestibular and visual dysfunction. The drugs specified included ethambutol, pyrazinamide and isoniazid (Sanchez-Sellero & Soto-Valera 2016).…”

Section: Discussionmentioning

confidence: 99%

“…Sanchez-Sellero and Soto-Valera (2016) found an association between three anti-TB therapy drugs and the development of vestibular and visual dysfunction. The drugs specified included ethambutol, pyrazinamide and isoniazid (Sanchez-Sellero & Soto-Valera 2016). Because none of our participants reported a diagnosed vestibular disorder at the time of recruitment, and were managed with these specific anti-TB drugs, it is possible that this had an influence on how they performed during the more challenging balance tests over the 6-month period.…”

Section: Discussionmentioning

confidence: 99%

Investigation of physical and functional impairments experienced by people with active tuberculosis infection: A feasibility pilot study

Aswegen¹,

Roos²,

McCree³

et al. 2019

Afr. j. disabil.

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Background: Tuberculosis (TB) remains a significant healthcare problem. Understanding physical and functional impairments that patients with active TB present with at the time of diagnosis and how these impairments change over time while they receive anti-TB therapy is important in developing appropriate rehabilitation programmes to optimise patients’ recovery.Objectives: The aim of this study was to assess the acceptability, implementation and practicality of conducting a prospective, observational and longitudinal trial to describe physical and functional impairments of patients with active TB.Method: A feasibility pilot study was performed. Patients with acute pulmonary TB admitted to an urban quaternary-level hospital were recruited. Physical (muscle architecture, mass and power, balance, and breathlessness) and functional (exercise capacity) outcomes were assessed in hospital, and at 6 weeks and 6 months post-discharge. Descriptive statistics were used to analyse the data.Results: High dropout (n = 5; 41.7%) and mortality (n = 4; 33.3%) rates were observed. Limitations identified regarding study feasibility included participant recruitment rate, equipment availability and suitability of outcome measures. Participants’ mean age was 31.5 (9.1) years and the majority were human immunodeficiency virus (HIV) positive (n = 9; 75%). Non-significant changes in muscle architecture and power were observed over 6 months. Balance impairment was highlighted when vision was removed during testing. Some improvements in 6-minute walk test distance were observed between hospitalisation and 6 months.Conclusion: Success of a longitudinal observational trial is dependent on securing adequate funding to address limitations observed related to equipment availability, staffing levels, participant recruitment from additional study sites and participant follow-up at community level. Participants’ physical and functional recovery during anti-TB therapy seems to be limited by neuromusculoskeletal factors.

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Section: Introductionmentioning

confidence: 99%

“…It is well established that in the initial stages of cochleotoxicity, high-frequency hearing is most affected due to the vulnerability of basal-end cochlear outer hair cells to oxidative stress (Lanvers-Kaminsky et al 2017). Significant vestibulotoxicity is associated with apoptosis or neurosis of the labyrinthine inner hair cells and oxidative stress to the labyrinths (Sedo-Cabezon et al 2014; Sanchez-Sellero & Soto-Varela 2016), resulting in functional impairments of imbalance and dizziness (Prayuenyong et al 2018). The misuse of illicit drugs, prescription opioids, and/or alcohol may induce similar patterns of hearing and vestibular dysfunction as ototoxic medications, but as this review will highlight, there is a substantial lack of knowledge of the potential mechanisms and in-depth rigorous studies that account for individual patient factors (e.g., exposure time, concentrations or dosage, the influence of polypharmacy, or medical comorbidities).…”

Section: Introductionmentioning

confidence: 99%

The Effects of Substance Misuse on Auditory and Vestibular Function: A Systematic Review

Chiao,

Hughes,

Karimuddanahalli Premkumar

et al. 2023

Ear &Amp; Hearing

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Background: Chronic substance misuse is an ongoing and significant public health concern. Among a myriad of health complications that can occur, substance misuse potentially causes ototoxic effects. Case reports, retrospective chart data, and a few cohort studies suggest that certain prescription opioids and illicit drugs can have either temporary or permanent effects on auditory and/or vestibular function. Given the steady rise of people with a substance-use disorder (SUD), it is of growing importance that audiologists and otolaryngologists have an insight into the potential ototoxic effects of substance misuse. Objectives: A systematic review was conducted to (1) synthesize the literature on the illicit drugs, prescription opioids, and alcohol misuse on the auditory and vestibular systems, (2) highlight common hearing and vestibular impairments for each substance class, and (3) discuss the limitations of the literature, the potential mechanisms, and clinical implications for clinicians who may encounter patients with hearing or vestibular loss related to substance misuse, and describe opportunities for further study. Design: Systematic searches were performed via PubMed, Scopus, and Google Scholar, and the final updated search was conducted through March 30, 2022. Inclusion criteria included peer-reviewed articles, regardless of study design, from inception until the present that included adults with chronic substance misuse and hearing and/or vestibular complaints. Articles that focused on the acute effects of substances in healthy people, ototoxicity from already known ototoxic medications, the relationship between hearing loss and development of a SUD, articles not available in English, animal work, and duplicates were excluded. Information on the population (adults), outcomes (hearing and/or vestibular data results), and study design (e.g., case report, cohort) were extracted. A meta-analysis could not be performed because more than 60% of the studies were single-case reports or small cohort. Results: The full text of 67 studies that met the eligibility criteria were selected for the review. Overall, 21 studies reported associations between HL/VL related to illicit drug misuse, 28 studies reported HL/VL from prescription opioids, and 20 studies reported HL/VL related to chronic alcohol misuse (2 studies spanned more than one category). Synthesis of the findings suggested that the misuse and/or overdose of amphetamines and cocaine was associated with sudden, bilateral, and temporary HL, whereas HL from the combination of a stimulant and an opioid often presented with greater HL in the mid-frequency range. Reports of temporary vertigo or imbalance were mainly associated with illicit drugs. HL associated with misuse of prescription opioids was typically sudden or rapidly progressive, bilateral, moderately severe to profound, and in almost all cases permanent. The misuse of prescription opioids occasionally resulted in peripheral VL, especially when the opioid misuse was long term. Chronic alcohol misuse tended to associate with high-frequency sudden or progressive sensorineural hearing loss, or retrocochlear dysfunction, and a high occurrence of central vestibular dysfunction and imbalance. Conclusions: Overall, chronic substance misuse associates with potential ototoxic effects, resulting in temporary or permanent hearing and/or vestibular dysfunction. However, there are notable limitations to the evidence from the extant literature including a lack of objective test measures used to describe hearing or vestibular effects associated with substance misuse, small study sample sizes, reliance on case studies, lack of controlling for confounders related to health, age, sex, and other substance-use factors. Future large-scale studies with prospective study designs are needed to further ascertain the role and risk factors of substance misuse on auditory and vestibular function and to further clinical management practices.

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Instability Due to Drug-Induced Vestibulotoxicity

Cited by 8 publications

References 19 publications

Changes in vestibular and cochlear function following platinum-based chemotherapy: A preliminary report

Changes in vestibular and cochlear function following platinum-based chemotherapy: A preliminary report

Investigation of physical and functional impairments experienced by people with active tuberculosis infection: A feasibility pilot study

The Effects of Substance Misuse on Auditory and Vestibular Function: A Systematic Review

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