Ototoxicity

Abstract

This paper reviews intriguing recent findings on the mechanisms of drug induced hearing loss caused by two major classes of therapeutic agents: the aminoglycoside antibiotics and cisplatin. Both drug categories are nephrotoxic as well as ototoxic. Aminoglycosides and cisplatin target the outer hair cells in the basal turn of the cochlea to cause high frequency sensorineural hearing loss in a substantial percentage of patients treated with these drugs. Each group of agents appears to generate reactive oxygen species within the cochlea that trigger downstream mechanisms leading to cell death. Various protective agents including antioxidants show promise in protecting the inner ear from damage in experimental animals. The only successful double-blind, placebo controlled clinical trial using a protective agent to prevent ototoxicity was carried out in China. Aspirin or placebo was given in combination with gentamicin. A significant decrease in hearing loss was observed. Successful clinical implementation of protective agents will require a cautious approach, so that the therapeutic effect of the anti-infective agent or anti-neoplastic drug is not attenuated. This may require novel methods of administration of protective agents, such as injection within the middle ear. This would provide a maximal dose of protective agent without systemic interference with the desired effect of the ototoxic agent.

Ginkgo biloba and Lycopene are Effective on Cisplatin Induced Ototoxicity?

“…It may be a temporary or a permanent loss. It is observed bilaterally in general [18] . In a study by Pollera et al [19] , the hearing loss after the first dose of cisplatin occurred in the first 48 h and above 4 kHz.…”

Oxymorphone Insufflation Associated with Acute Sensorineural Hearing Loss: Case Files of the University of Massachusetts Medical Toxicology Fellowship

“…Hearing loss associated with these therapeutic agents may be permanent and affects a significant proportion of treated individuals. As many as 33 % of patients treated with aminoglycosides experience ototoxicity [5], while 60 % of children treated with cisplatin suffer from permanent bilateral hearing loss [6]. Imatinib, a chemotherapeutic tyrosine kinase inhibitor, has also been associated with hearing loss in a case report of a young man receiving treatment for chronic myeloid leukemia [7].…”

Chemical exposure and hearing loss

“…Cell death may also result from caspase-independent mechanisms. 21 Anti-neoplastic drugs-Platinum-derivates such as cisplatin and carboplatin are anticancer drugs that have ototoxic side effects. [22][23][24] The ototoxicity induced by platinumderivates is characterized by the loss of cochlear hair cells and cells of the spiral ganglion and by degeneration of the stria vascularis.…”