Dr. Joan Englehart Rodriguez, Au.D., joined Dr. Goldberg’s Suwanee practice in 2007 with 28 years’ experience in clinical audiology. A native of Pennsylvania, she earned her Bachelor of Art degree in Hearing and Speech Sciences from the University of Maryland in 1978 and her Master of Science degree in Audiology from Penn State University in 1979. In 2003 she received her Doctor of Audiology degree (Au.D.) from the Arizona School of Health Sciences.
Ototoxic refers to something that is poisonous to the iXnner ear. Within the framework of hearing loss, it refers to medicine that adversely affects the organs and nerves connected to hearing and balance. Medications that are toxic to the inner ear can manifest instantly or gradually over the course of time. The level of damage incurred is dependent upon the type of medication taken and the length of time it was prescribed. Early detection is crucial because without it, ototoxicity can result in serious hearing loss and balance problems, tinnitus or “ringing in the ears” or very minor hear loss.
Symptoms of Ototoxicity
Tinnitus which can present itself like a ringing sound can also sound like a hum, buzz or hiss and is an agitating condition. Sounds that have a high frequency or a speech set in a noisy background may become harder to detect. These symptoms can occur in one or both ears.
Problems with balance show up in the form of dizziness or disorientation, causing us to experience a lack in equilibrium. This in turn creates problems when walking, climbing or even standing up. If any of these activities are done in the low light situations the condition is exacerbated. Problems with eyesight can also occur in extreme cases. Vision might become blurry or jumpy and any head motion can result in images being disjointed.
Which medications do we need to monitor?
Within our inner ear lies the mechanisms for the transmission of sound to the brain the cells that degenerate due to aging, noise pollution or genetics to name a few causations, are poisoned by intake of ototoxic medications. These medications are can be necessary for the treatment of cancer, heart disease and a variety of other conditions.
The following are some examples of medications you should be aware of:
- Antibiotics – aminoglycoside and macrolide
- Chemotherapeutic agents – Cisplatin
- Antimalarials
- Non-steroidal anti-inflammatory drugs (NSAIDs)
- Acetaminophen
The above list is not comprehensive but is presented to give you an overall idea of what can detrimental. It is necessary to consult your hearing health physician and/or your other attending doctors with any questions or concerns you have may have regarding your treatment and prescriptions. In accordance to a report made available by the Center of Disease Control in January of 2018, it reveals the significance of ototoxic medications on hearing loss for an aging population in the following statement: ”Our findings support that known ototoxic medications are widely used for treating various conditions and ototoxicity may interact with aging leading to a more severe hearing loss than that associated with age alone. Given the high prevalence of hearing loss and its impact on health and activities of daily living, the high prevalence of ototoxic medication use by older adults may be a critical public health problem.”
What can we do?
The good news is that we can take the initiative with repeated and regular testing to monitor for any symptoms of ototoxicity. Tests are available, such as the ABR or Auditory brainstem response test measures the responses by of the hearing nerve and hearing centers in the brain. The electronystagmogram (ENG) provides an assessment of balance. These tests might be administered by your audiologist for a comprehensive insight into possible ototoxicity. Audiologists often work in tandem with other doctors to make sure your hearing health stays on track.
How can we deal with the effects?
Make sure you communicate your issues to your physician as well as your audiologist. Medications and dosages can be changed dependent upon the diagnosis of your doctors to prevent or minimize the effects of ototoxicity.
A hearing health professional can also help you with listening implements suited to your needs. For example, an FM system for loud environments at work or home, provides amplification to improve your hearing. The use of hearing aids which an audiologist will prescribe and fit according to your specific requirements. They are adjustable, non-invasive, and are available in many forms with technology consistently improving to fine tune to the needs of your hearing condition.
In fact, hearing aids are highly recommended by the CDC for use as soon as hearing loss is detected and prescribed for use to stem further hearing loss and elevate your hearing experience.