Ototoxicity (OTTX)
Ototoxicity (OTTX): Definition and Characteristics
What is Ototoxicity (OTTX)?
Ototoxicity (OTTX) refers to damage to the inner ear—specifically the cochlea or vestibular system—caused by exposure to certain toxic substances, most commonly medications or chemicals. This damage can impair hearing or balance functions and may result in symptoms such as hearing loss, tinnitus (ringing in the ears), dizziness, vertigo, or imbalance.
Characteristics
Mechanism: Ototoxic agents damage auditory and vestibular hair cells or neurons through mechanisms including oxidative stress, mitochondrial dysfunction, and disruption of ion homeostasis. These effects lead to sensorineural hearing loss and vestibular dysfunction.
Symptoms: Patients may experience gradual or sudden hearing loss, persistent tinnitus, difficulty understanding speech in noisy environments, and balance disturbances such as unsteadiness, dizziness, or vertigo. Severity depends on the type, dose, duration of exposure, and individual susceptibility.
Risk Factors: Use of multiple ototoxic drugs, pre-existing hearing impairment, kidney dysfunction, and prolonged treatment increase the risk of ototoxicity.
Clinical Significance
Ototoxicity is a major concern in clinical settings, especially with drugs like aminoglycoside antibiotics, loop diuretics, nonsteroidal anti-inflammatory drugs, and platinum-based chemotherapy agents such as cisplatin. Early detection through audiological monitoring is essential to prevent irreversible damage. Management includes dose adjustment, drug substitution, and symptomatic treatment with hearing aids or vestibular therapy when indicated.
Key Points
Ototoxicity is toxic damage to the ear’s hearing and balance structures from certain drugs or chemicals.
Manifestations include sensorineural hearing loss, tinnitus, dizziness, and balance problems.
Risk increases with cumulative exposure, combination therapies, and predisposing conditions.
Prevention, early detection, and supportive care are critical to minimize functional impairment.
Consult with Our Team of Experts Now!
For diagnosis and management of ototoxicity or risks related to ototoxic medications, consult with our audiology and otolaryngology specialists for tailored care using Cellular Immunotherapies.
References:
- Steyger PS. Mechanisms of Ototoxicity and Otoprotection. Otolaryngol Clin North Am. 2021 Dec;54(6):1101-1115. doi:10.1016/j.otc.2021.08.007. Available at: https://pubmed.ncbi.nlm.nih.gov/34774227/
- Hashino E, Shero M. Cellular mechanisms of ototoxicity. Front Cell Neurosci. 2018 Mar 26;12:75. doi:10.3389/fncel.2018.00075. Available at: https://www.frontiersin.org/articles/10.3389/fncel.2018.00075/full
- Rybak LP, Ramkumar V. Ototoxicity. Kidney Int. 2007 Apr;72(12):1456-62. doi:10.1038/sj.ki.5002694. Available at: https://www.sciencedirect.com/science/article/pii/S008525381552766X
- Morell DJ, Schacht J. Ototoxicity: a high risk to auditory function that needs to be addressed. Front Mol Neurosci. 2024 Aug;17:1379743. doi:10.3389/fnmol.2024.1379743. Available at: https://www.frontiersin.org/articles/10.3389/fnmol.2024.1379743/epub
- Bielefeld EC, Kopke RD. Mechanisms of aminoglycoside ototoxicity and otoprotection. Am J Audiol. 2008 Jun;17(2):148-54. doi:10.1044/1059-0889(2008/016). Available at: https://pubs.asha.org/doi/10.1044/hhd9.1.2
