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Drug-Induced Ototoxicity: Diagnosis and Monitoring

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Abstract

Ototoxicity diagnosis and management has historically been approached using a variety of methods. However, in recent years a consensus on useful and practical approaches has been developed through clinical guidelines of the American Speech Language Hearing Association, the American Academy of Audiology, and multiple clinical trials published in peer-reviewed literature. Some of the guidelines and approaches are used to detect and monitor ototoxicity, while others are used to grade adverse events. Some of the audiologic measures are primary, while others are adjunct measures and may be tailored to the specific needs of the patient or clinical trial. For some types of monitoring, such as drug-induced tinnitus or dizziness, validated paper survey instruments can be both sensitive and easy for fragile patients. This review addresses the characteristics of some of the most common clinical ototoxins and the most common methods for detecting and monitoring ototoxicity in clinical practice and clinical trials.

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Authors and Affiliations

  1. Department of Medical Microbiology, Immunology and Cell Biology, Southern Illinois University School of Medicine, PO Box 9626, Springfield, IL, 62704-9626, USA

    Kathleen C. M. Campbell

  2. Callier Center for Communication Disorders, University of Texas at Dallas, 1966 Inwood Road, Dallas, TX, 75235, USA

    Colleen G. Le Prell

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Conflicts of interest

Kathleen Campbell is a Distinguished Scholar and Professor at Southern Illinois University School of Medicine, Springfield, IL, USA. In that capacity, she has had grants from multiple funding sources, including the National Institutes of Health and the US Department of Defense, for her research on ototoxicity and noise-induced hearing loss. In addition, she serves as a grant reviewer for those agencies. She also has served as, and continues to serve as, an ototoxicity/audiology consultant for various Pharmaceutical Companies. She is a shareholder in AudiaCare and is the inventor on patents for D-methionine as an otoprotective agent. She receives royalties for her textbook Pharmacology and Ototoxicity for Audiologists, and occasionally receives honoraria for her lectures at professional associations. Colleen Le Prell is the Emily and Phil Schepps Distinguished Professor of Hearing Science at the University of Texas, Dallas, TX, USA, where she also serves as Head of the AuD program. She has had grants from multiple funding sources, including the National Institutes of Health and the US Department of Defense, for her research on noise-induced hearing loss. She has served as an ad hoc grant reviewer for those agencies, and is currently serving on the Safety and Occupational Health study section for the National Institute of Occupational Safety and Health. She has also supervised industry contracts, supported by pharmaceutical companies, including Sound Pharmaceuticals, Edison Pharmaceuticals, and Hearing Health Science, and is an inventor on patents owned by the University of Michigan and University of Florida. She receives royalties for her book Noise-Induced Hearing Loss: Scientific Advances and occasionally receives honoraria for her lectures at professional associations. Both authors have no other potential conflicts of interest that are directly relevant to the content of this article.

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Campbell, K.C.M., Le Prell, C.G. Drug-Induced Ototoxicity: Diagnosis and Monitoring. Drug Saf 41, 451–464 (2018). https://doi.org/10.1007/s40264-017-0629-8

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