Each year, more than 500,000 cases of hearing loss around the world can be attributed to the use of ototoxic medications. Researchers from the Department of Otolaryngology and Head and Neck Surgery at the University of California, San Francisco (UCSF OHNS) and Harvard Medical School (HMS) recently addressed the use of these drugs and management of resulting hearing loss, in the unfortunate event of ototoxicity.
The team authored "Prevention and management of hearing loss in patients receiving ototoxic medications," published in the Bulletin of the World Health Organization (WHO). In the article, the investigators review ototoxic drugs; propose a new framework for early detection, management and treatment; and identify areas for future research, especially in low-resource areas.
The article comes as a response to updated WHO guidelines for the treatment of multidrug-resistant tuberculosis, which advised against the use of drugs that can cause hearing loss. Those updates "reaffirmed patients' right to hearing," note the authors.
"There remain significant gaps in our understanding about optimal screening and treatment of ototoxic hearing loss," write the authors, led by first author Michael Lindeborg, MD, a third-year resident at UCSF OHNS. In the article, the investigators "aim to inspire future international guidelines to address gaps in ototoxicity care and establish research agendas for eliminating ototoxic medications."
In a table, the authors delineate various ototoxic drugs, the mechanism of ototoxicity and the type — irreversible or reversible — and provide guidelines for monitoring hearing loss for each type. The authors also provide a case study and an infographic to offer additional insights and information to providers. Their work aims to improve screening and treatment for ototoxic hearing loss across multiple healthcare settings, including those in low- and middle-income countries.
"New treatment options and revised guidelines will protect millions of people from unnecessary exposure to drugs that cause irreversible hearing loss," write Lindeborg et al. "When agents that result in irreversible hearing loss are the only option, evaluation and adoption of internationally recognized guidelines are needed, alongside additional research, to prevent, manage and treat this unfortunate adverse event."
The senior author of the paper is Carole Mitnick of the Department of Global Health and Social Medicine at HMS. Co-authors of the paper include David Jung, MD, PhD, of the HMS Department of Otolaryngology and Dylan Chan, MD, PhD, an associate professor in residence at UCSF OHNS and the director of the Children's Communication Center.
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