Pharmacological ototoxicity

Biologically active substances, such as certain categories of drugs, can induce a whole set of effects on the structures of the inner ear, auditory and/or vestibular system, which outline a specific nosological entity, the toxicity. The clinical variety of pharmacological ototoxicity is also attributable to the multiplicity of categories of drugs with potentially ototoxic action, even if some of these can be defined as “canonical” such as that of some antibiotics - aminoglycosides, macrolides, glycopeptides - loop diuretics, antimalarials, non-steroidal anti-inflammatory drugs, some chemotherapeutic agents (cisplatin and derivatives), antiretrovirals. The complexity of this pathology is also reflected in the epidemiological profile, since it is not possible to use homogeneous statistical data, not only due to the differences in the different criteria that are adopted for the purposes of nosological classification, but also due to the variability of the extent of detection and of the logistical possibilities. provision of relevant data, varying these factors in relation to the genetic diversity of the various ethnic groups, the lack of homogenization of the methods of investigation, as well as the socio-economic status of the various countries. The irreversibility of hearing damage caused by ototoxic drugs implies the establishment of early audiological rehabilitation procedures that involve the use of hearing aids, cochlear implants, communication aids, such as frequency modulation systems in classes with patients suffering from ototoxicosis, a set of measures whose adoption is linked not to the simple result of the audiometric tests, but to the overall communication difficulties of individual patients.