What Is Ototoxicity? Symptoms, Causes, and Hearing Loss Risks

Written by Autumn Benoot, M.Cl. Sc. Audiologist

Ototoxicity is a term used to describe damage to the inner ear that is caused by certain medications. Our inner ear is made up of very delicate hair cells that vibrate and send sound to our brain via the auditory nerve. These hair cells, especially those responsible for  high frequency sounds, are very susceptible to ototoxic medications, such as chemotherapy agents (ex. Cisplatin, Carboplatin), certain antibiotics (aminoglycosides), and even high doses of aspirin, which can negatively impact our hearing, balance, or both. It can also create or worsen ringing in our ears, which is known as tinnitus.

Hearing loss from ototoxic medications can occur suddenly or gradually and can range in severity. Many patients we see at our clinics that have been exposed to ototoxic medications experience high-pitch ringing in their ears, muffled hearing, or difficulty understanding speech (especially in noisy environments). Others may experience dizziness or feel off-balance. Symptoms tend to vary depending on which medication you are taking and how long you’ve been using it for.

With this being said, ototoxicity does not affect everyone the same way. Sometimes symptoms can be temporary and improve when the medication is stopped. In other cases, ototoxicity can cause permanent and irreversible damage to our inner ear. This is why it is important to monitor any changes in hearing or balance while taking ototoxic medications.

Regular hearing checkups, especially before and during treatment, are vital as early detection can help manage symptoms. During a hearing assessment, speech in noise tests, alongside extended high frequency audiometry, can help determine the full impact ototoxic medications have on your inner ear and overall hearing health.