All About Ototoxic Hearing Loss

All About Ototoxic Hearing Loss

In Hearing Health, Hearing Loss by Jeff Baller, Au.D., CCC-A

Jeff Baller, Au.D., CCC-A
Latest posts by Jeff Baller, Au.D., CCC-A (see all)

The two most common forms of hearing loss are noise-induced, whereby exposure to loud sound over time has a damaging effect on the inner ear, and age-related, wherein something about the aging process causes a dysfunction of hearing ability. Most of our thinking and research about hearing loss revolves around these types, but what about ototoxic hearing loss? Although less common than these dominant causes, ototoxic hearing loss can be caused by at least 200 different medications. Let’s take a moment to understand how ototoxic hearing loss works, as well as what you can do to protect yourself. 


What exactly is an ototoxic substance? In short, these substances are ones that can cause hearing loss, as well as balance disorders of the inner ear. Many of these are harmful chemicals that can hurt other parts of the body as well, but some of these substances are used in medications. 

When it comes to high degrees of ototoxicity or high probability that the drug will cause hearing loss, a physician and patient enter into a conversation about the benefits of the drug and the likelihood of hearing loss. In addition to the ototoxic substances used in medications, some of these chemicals can be found in industrial workplaces and manufacturing. 

The Occupational Health and Safety Administration (OSHA) is tasked with ensuring that proper protocols are followed when it comes to hearing health, reducing these ototoxic effects to a minimum. Although they work in many different ways, the most common form of ototoxicity has to do with the fragility of the tiny hairlike organelles of the inner ear called stereocilia. These cells are sensitive to slight differences in vibrations of the fluid in the inner ear, but that same sensitivity makes them prone to damage and breaking. 

Once they are damaged, the inner ear does not “re-grow” new stereocilia, making permanent hearing loss a reality. Ototoxic substances can deprive the stereocilia of what they need to function, making hearing loss a reality. 

Ototoxic Substances

What are some of the ototoxic substances that you might encounter? Most of them come in the form of medications, and some have a more powerful ototoxic effect than others. Some antibiotics can be ototoxic, such as the aminoglycoside gentamicin, so you might want to explore alternatives with your physician if one of these is recommended. Check the warning label at the pharmacy to make sure you’re aware of these potential effects. 

Quinine, a substance used for its antimalarial properties, has now been discovered to have ototoxic effects, as well, but these effects are usually temporary and only occur after a long period of use. Hydroxychloroquine, a drug administered for some time as a response to COVID-19 with varying success, can have similar rates of ototoxicity as quinine. Some pain relievers such as aspirin and acetaminophen can cause hearing loss when they are prescribed at very high doses for a long period of time, and the person who uses these substances from time to time need not worry about hearing loss. 

The most powerful ototoxic effects come with the most powerful drugs. Chemotherapy is a chemical treatment for many types of cancer, inundating the body with harmful chemicals that eradicate the cancerous cells. When a person has cancer at a stage that requires this type of treatment, ototoxic hearing loss can be an effect. The conversation with a physician will often balance side effects such as hearing loss against the likelihood of success with the treatment. 

Treatment for Hearing Loss

Although ototoxic chemicals can cause permanent hearing loss, that doesn’t mean that nothing can be done. When hearing ability has been reduced in a certain range of sound, hearing aids can step in and provide the amplification necessary to be able to hear these sounds again. With the recent developments in hearing aid technology, it is remarkable just how much a person’s hearing ability can transform with treatment. 

If you are concerned about ototoxic hearing loss, consult with us! Contact us today to schedule an appointment for a hearing test and consultation.