Semin Hear 2019; 40(02): 085-086
DOI: 10.1055/s-0039-1685161
Preface
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Pharmacology and Ototoxicity

Robert M. DiSogra Guest Editor
1   School of Communication Disorders and Deafness, Kean University, Union, New Jersey
› Author Affiliations
Further Information

Publication History

Publication Date:
26 April 2019 (online)

There continues to be a growing interest in pharmacology and ototoxicity within the audiology community, the medical community, and with researchers throughout the world. Historically, research has focused on the ototoxic effects of various classes of drugs as well as reversibility of damage. Adverse drug reactions include hearing loss, tinnitus, cognitive issues, vestibular dysfunction, or in combination. Pharmaceuticals and nutraceuticals (over-the-counter dietary supplements and other botanicals) have been more recently studied with the primary goal of either otoprotection or reducing the risk of the ototoxic side effects of these drugs. Currently, there are no nutraceuticals for hearing loss, vestibular dysfunction, and/or tinnitus approved by the U.S. Food and Drug Administration.

Over the past 10 years, more pharmacology and biomedical science courses have been added to the current curricula in established doctor of audiology programs. Audiology doctoral education is expanding. To that end, this issue offers a primer for pharmacology for the audiologist. There continues to be a need for new knowledge as well as support for research in these areas. The reader can review the current clinical trials relative to ototoxicity by visiting the National Library of Medicine's Clinical Trials database at www.clinicaltrials.org. Because the health benefits of platinum-based drugs or aminoglycoside (AMG) antibiotics outweigh their ototoxic effects, counseling, amplification, and hearing assistance technologies become a major part of the management plan.

This issue of Seminars in Hearing brings together some of the most knowledgeable and well-respected audiologists, otologists, and pharmacologists from this country and South Africa who will impart the most up-to-date information for our colleagues that is not only clinically important but practically useful for your next patient.

Audiologists are the experts in the evaluation of and the nonmedical management of hearing and balance problems. To that end, there is a manuscript on the side effects of pharmaceuticals on audiological and vestibular testing. A reference chart of AMG antibiotics and platinum-based drugs is included. The chart identifies over 20 drugs and their risk of hearing/balance problems and whether the problem is reversible once the medication is discontinued.

Research into otoprotectants and otorescue agents is emerging and will translate basic science into applications for hearing conservation programs, safety operations, and, of course, clinical care. To visualize the complexities of this landscape, a concept map has been developed and appears in this issue.

Cisplatin-associated ototoxic properties are examined along with their clinical signs used to identify patients at risk of developing a hearing impairment. In addition, the mechanisms of cisplatin-induced ototoxicity and various strategies tested to prevent hearing loss are presented.

Pediatric ototoxicity grading and monitoring protocols are examined along with objective and subjective monitoring protocols for both cochleotoxicity and vestibulotoxicity.

When we address the issue of reducing the risk of noise-induced hearing loss (NIHL), an exciting new research field has emerged using compounds referred to as otoprotectants. Prevention of NIHL continues to be a major challenge for military personnel and workers in a variety of industries despite the requirements that at-risk individuals use hearing protection devices such as ear plugs or ear muffs. To that end, there is an exciting study on the state of the art of otoprotectants.

Finally, in addition to all the excellent contributions by the distinguished authors in this issue, our respective billing departments must be made aware of the new ICD-10 diagnostic codes. Choosing the appropriate codes for these specific patients is critical not only for payment for services rendered but also has implications nationally and globally, given that their utilization is tracked for mortality and morbidity statistics and potential policies. To that end, we have included an excellent reference article on this issue.

Pharmacology education for audiologists continues to expand. Improved management strategies for ototoxic drug monitoring and hearing loss prevention with otoprotectants are entering a new phase in the audiologist's scope of practice.

Our contributors have certainly added to that body of knowledge. I hope you will agree.