Otolaryngology Online Journal

All submissions of the EM system will be redirected to Online Manuscript Submission System. Authors are requested to submit articles directly to Online Manuscript Submission System of respective journal.
Reach Us +44 151 808 1136

Mini Review - Otolaryngology Online Journal (2025) Volume 15, Issue 1

Ototoxicity and Hearing Preservation: Strategies in Chemotherapy and Other Treatments

Aisha Rahman*

Department of ENT Research, University of All India Institute of Medical Sciences, India

*Corresponding Author:
Aisha Rahman
Department of ENT Research, University of All India Institute of Medical Sciences, India
E-mail: aisha.rahman@example.in

Received: 02-Jan-2025, Manuscript No. JORL-25-162863; Editor assigned: 03-Jan-2025, PreQC No. JORL-25-162863 (PQ) Reviewed:17-Jan-2025, QC No. JORL-25-162863Revised:24-Jan-2025, Manuscript No. JORL-25-162863 (R); Published:28-Jan-2025, DOI: 10.35841/2250-0359-15.1.427

Visit for more related articles at Otolaryngology Online Journal

Introduction

Ototoxicity refers to damage caused to the inner ear or auditory nerve by pharmaceutical agents, resulting in hearing loss or balance issues. One of the most concerning causes of ototoxicity is chemotherapy, as many cancer treatments involve drugs known to cause hearing impairment. These effects are often irreversible and can significantly impact a patient’s quality of life [1]. This short communication discusses the issue of ototoxicity in chemotherapy and other treatments, highlighting the importance of hearing preservation strategies and exploring potential approaches to mitigate the risk of hearing loss [2].

Chemotherapeutic agents such as cisplatin, carboplatin, and other platinum-based drugs are among the most common causes of ototoxicity. Cisplatin, in particular, has been widely used in treating various cancers, including ovarian, lung, and head and neck cancers. While these drugs are highly effective at targeting cancer cells, they also cause damage to the cochlea, the auditory portion of the inner ear, by inducing oxidative stress and triggering inflammation. The resulting damage can lead to permanent sensorineural hearing loss, often starting with high-frequency hearing loss, which can progress over time. The degree of ototoxicity varies between individuals, and factors such as age, genetic predisposition, cumulative dose, and duration of chemotherapy play critical roles in determining susceptibility. Children are particularly vulnerable to the effects of ototoxicity due to the developmental nature of their auditory systems, and hearing loss in pediatric patients can have significant implications for speech and language development [3].

In addition to chemotherapy, ototoxicity can also result from treatments used for infections, such as aminoglycoside antibiotics (e.g., gentamicin), certain diuretics like furosemide, and some antimalarial drugs. While these medications are essential in managing various medical conditions, their potential to damage the inner ear necessitates careful monitoring during treatment. Patients undergoing radiation therapy to areas near the head and neck may also be at risk for hearing loss, especially if the cochlea or other parts of the auditory pathway are exposed to radiation. The risk is higher when radiation is combined with chemotherapy [4].

Given the potentially debilitating effects of ototoxicity, there is a growing emphasis on hearing preservation strategies in the treatment of cancer and other conditions. Several approaches are being explored to reduce the risk of hearing loss or to preserve hearing function during chemotherapy and other treatments. One of the most critical strategies in managing ototoxicity is early monitoring of hearing function. Regular hearing tests, such as audiometry, should be conducted before, during, and after treatment to track any changes in hearing and detect ototoxicity at the earliest possible stage. Early detection allows for the timely intervention to modify or discontinue ototoxic drugs when necessary. For pediatric patients, otoacoustic emissions (OAE) testing and auditory brainstem response (ABR) testing can help detect hearing loss before it becomes clinically apparent. Several otoprotective agents have been studied for their ability to prevent or reduce chemotherapy-induced hearing loss. Amifostine, a cytoprotective agent, has shown some promise in reducing the ototoxic effects of cisplatin, although its use remains somewhat limited due to concerns over side effects and its potential to reduce the effectiveness of chemotherapy. Other agents, such as L-carnitine and N-acetylcysteine, are being explored for their antioxidant properties, which may help mitigate oxidative stress and reduce hearing damage [5-8].

For patients receiving chemotherapy with ototoxic drugs, dose adjustment and treatment modification can be effective strategies to minimize hearing loss. Reducing the dose of the offending drug, switching to alternative chemotherapy agents that are less ototoxic, or altering the frequency of dosing may reduce the risk of ototoxicity without compromising the effectiveness of cancer treatment. This approach requires careful balancing by oncologists and otolaryngologists to ensure that cancer treatment remains effective while preserving hearing. In cases where hearing loss does occur despite prevention efforts, auditory rehabilitation becomes an essential part of the management plan. The use of hearing aids or cochlear implants can help individuals with significant hearing loss regain some level of auditory function. For children, early intervention with speech therapy and the use of assistive listening devices is crucial to mitigate the impact of hearing loss on language and academic development.

While current strategies have improved the management of ototoxicity, there is still much to be done in the quest for effective prevention and treatment [9,10]. Ongoing research is focused on discovering new otoprotective agents and refining existing treatments. Gene therapy and stem cell therapy are exciting areas of research that hold promise for repairing or regenerating damaged hair cells in the cochlea, potentially offering a future solution for reversing hearing loss caused by ototoxicity.

Conclusion

Ototoxicity remains a significant concern for patients undergoing chemotherapy and other treatments, as hearing loss can severely impact a patient's quality of life. Through early monitoring, protective strategies, treatment adjustments, and auditory rehabilitation, the risk of hearing loss can be minimized. However, continued research and innovation are needed to develop more effective strategies for hearing preservation and to provide better outcomes for those affected by ototoxicity. By combining current preventive measures with emerging technologies, healthcare providers can improve the overall management of ototoxicity and help preserve the hearing of those undergoing life-saving treatments.

References

  1. Patel PN, Most SP. Concepts of facial aesthetics when considering ethnic rhinoplasty. Otolaryngologic Clinics of North America. 2020;53(2):195-208.

    2. Indexed at, Google Scholar, Cross Ref

  2. Broer PN, Buonocore S, Morillas A, et al. Nasal aesthetics: a cross-cultural analysis. Plastic and reconstructive surgery. 2012;130(6):843e-50e.

    3. Indexed at, Google Scholar, Cross Ref

  3. Patel SM, Daniel RK. Indian American rhinoplasty: an emerging ethnic group. Plastic and Reconstructive Surgery. 2012;129(3):519e-27e.

    4. Indexed at, Google Scholar, Cross Ref

  4. Saad A, Hewett S, Nolte M, et al. Ethnic rhinoplasty in female patients: the neoclassical canons revisited. Aesthetic Plastic Surgery. 2018;42:565-76.

    5. Indexed at, Google Scholar, Cross Ref

  5. Lenehan S. Nose aesthetics: Rhinoplasty and identity in Tehran. Anthropology of the Middle East. 2011;6(1):47-62.

    6. Indexed at, Google Scholar, Cross Ref

  6. Leach J. Aesthetics and the Hispanic rhinoplasty. The Laryngoscope. 2002;112(11):1903-16.

    7. Indexed at, Google Scholar, Cross Ref

  7. Santos M, Azevedo SR, Dias D, et al. Preservation Rhinoplasty by the Ones Who Do It: A Worldwide Survey. Facial Plastic Surgery & Aesthetic Medicine. 2024.

    8. Indexed at, Google Scholar, Cross Ref

  8. Kwon SH, Lao WW, Lee CH, et al. Experiences and attitudes toward aesthetic procedures in East Asia: a cross-sectional survey of five geographical regions. Archives of Plastic Surgery. 2021;48(06):660-9.

    9. Indexed at, Google Scholar, Cross Ref

  9. Dayan S, Kanodia R. Has the pendulum swung too far? trends in the teaching of endonasal rhinoplasty. Archives of Facial Plastic Surgery. 2009;11(6):414-6.

    10. Indexed at, Google Scholar, Cross Ref

  10. Hicks KE, Thomas JR. The changing face of beauty: a global assessment of facial beauty. Otolaryngologic Clinics of North America. 2020;53(2):185-94.

    11.               Indexed at, Google Scholar, Cross Ref

Get the App