ABSTRACT
Ototoxicity is an unfortunate consequence of the availability and use of medications
that are used to prolong life by treating serious infections and cancer. Specifically,
aminoglycoside antibiotics and antineoplastic (chemotherapeutic) agents have the greatest
ototoxic potential, often resulting in permanent changes in hearing and/or balance.
Although there is ample evidence regarding changes in auditory function secondary
to treatment, and protocols have been established to monitor hearing during and following
each treatment course, less is known about the impact of medications and other agents
on the vestibular system. The purpose of this article is to discuss the audiological
management of vestibular ototoxicity. The discussion includes a description of the
clinical features of vestibular loss, the tools that are available to assess damage
to the vestibular system during treatment, and experimental evidence of the impact
of various agents on the auditory and vestibular systems. Selected cases are presented
to illustrate the variable presentation of vestibular loss across affected individuals,
as well as the complex relationship between hearing and vestibular system status.
Finally, various options for monitoring vestibular system function are proposed, including
a discussion of the pragmatic aspects of establishing a monitoring program.
KEYWORDS
Ototoxicity - aminoglycosides - monitoring - vestibular - oscillopsia
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Jaynee A HandelsmanPh.D.
Department of Otolaryngology Head and Neck Surgery, Vestibular Testing Center, University
of Michigan Health System, Room C166A Med Inn Building
1500 East Medical Center Drive, Ann Arbor, MI 48109
Email: Jaynee@med.umich.edu
