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Hearing Loss and Ototoxicity - Symptoms, Causes & Treatment

Kimberley Bradshaw - Head of Marketing
Written By:
Kimberley Bradshaw

Head of Customer Content Experience

David - Audiologist for Hearing Aid UK
Medically Reviewed By:

Audiology Expert at Hearing Aid UK

Updated and medically reviewed: 23rd May 2024
Ototoxicity and Hearing Loss

Ototoxicity and Hearing Loss

Symptoms, Causes & Treatment


Otoocivity and hearing loss overview

Ototoxicity refers to the harmful effects of certain medications or chemicals on hearing and balance. Common culprits include certain antibiotics, chemotherapy drugs, and high doses of aspirin. Symptoms may include hearing loss, tinnitus, or dizziness. Monitoring medication use and consulting with healthcare providers can help prevent or minimise ototoxicity-related hearing loss.

This article discusses the causes, symptoms, and treatment for ototoxicity.


What is ototoxic hearing loss?

Ototoxicity refers to the toxic effects that certain drugs, chemicals, and substances can have on the auditory system.  This is especially true for the cochlea, vestibular system, and auditory nerve. These substances can cause temporary or permanent hearing loss, tinnitus, and balance problems.

Ototoxicity is a serious issue that affects many individuals, including those who are being treated with certain medications, are exposed to chemicals in the workplace, or are regularly exposed to loud noises.  


Drugs - Ototoxic hearing loss causes

How do ototoxic drugs cause hearing loss?  One of the most common causes of ototoxicity is the use of certain medications, including aminoglycoside antibiotics, loop diuretics, and chemotherapy drugs. These medications can damage the hair cells and nerve fibers in the inner ear, leading to hearing loss and tinnitus.

If we look at antibiotics associated with ototoxicity and hearing loss - aminoglycoside antibiotics are often used to treat bacterial infections, but they can cause permanent hearing loss if used for an extended period of time or in high doses. Loop diuretics, which are used to treat conditions such as heart failure and kidney disease, can also cause hearing loss and tinnitus, particularly when given intravenously.

Other ototoxic hearing loss examples include Chemotherapy drugs, such as cisplatin, which can also cause ototoxicity, which can be temporary or permanent, depending on the dosage and duration of treatment.

These drugs are used to treat various types of cancer, and while they are highly effective in killing cancer cells, they can also damage the hair cells and nerve fibers in the inner ear. This can lead to hearing loss, tinnitus, and balance problems, which can have a significant impact on a patient's quality of life.


Chemicals - Ototoxic hearing loss causes

In addition to medications, exposure to certain chemicals and substances in the workplace can also cause ototoxicity. Individuals who work in industries such as construction, manufacturing, and agriculture may be exposed to chemicals such as solvents, heavy metals, and pesticides.  These can damage the inner ear and lead to hearing loss and tinnitus.


Ototoxicity and noise-induced hearing loss

Similarly, individuals who work in noisy environments, such as factories and airports, are at risk of developing noise-induced hearing loss, which is caused by exposure to loud noises over a prolonged period of time.


What is Ototoxicity?

Ototoxicity and Hearing Loss

 How does ototoxicity cause hearing loss?


Symptoms of ototoxicity

The symptoms of ototoxicity can vary depending on the severity and duration of the exposure. Some individuals may experience a temporary loss of hearing or ringing in the ears, while others may experience more severe symptoms, such as permanent hearing loss and balance problems. In some cases, the symptoms may not be noticeable until years after the exposure has occurred.


Ototoxic hearing loss treatment

Treatment for ototoxicity depends on the underlying cause and severity of the symptoms.  Does ototoxicity go away?  In some cases, the symptoms may resolve on their own once the exposure has stopped.

However, if the hearing loss is permanent or severe, hearing aids or cochlear implants may be necessary to improve the patient's hearing. Balance therapy may also be recommended for individuals who experience balance problems as a result of ototoxicity.


Preventing hearing loss caused by chemical (ototoxicity) and noise exposure

Is ototoxic hearing loss reversible?  Preventing ototoxicity is essential, particularly for individuals who are at high risk of developing hearing loss due to medication or chemical exposure. Patients who are being treated with medications that have the potential to cause ototoxicity should be closely monitored by their healthcare provider and have their hearing tested regularly.

Individuals who work in noisy environments or are exposed to chemicals should wear protective gear, such as earplugs and earmuffs, to reduce their risk of developing hearing loss.


In conclusion

Ototoxicity is a serious condition that can cause temporary or permanent hearing loss, tinnitus, and balance problems. It can be caused by medications, chemicals, and loud noises, and can have a significant impact on a patient's quality of life.

Treatment for ototoxicity depends on the underlying cause and severity of the symptoms, and prevention is key to avoiding this condition. Patients should be closely monitored by their healthcare providers and take steps to protect their hearing in order to reduce their risk of Ototoxicity hearing loss.

However, it is important to know that if you take any medication discussed in this article (or others associated with hearing loss), doesn't necessarily mean you will lose your hearing.  Each individual responds to medication differently, therefore the side effects can vary. 

Always chat with your GP about your concerns and the risks of hearing loss from the particular medication you are being prescribed - especially if it's for a long period of time.


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This article was written by Kimberley Bradshaw

Meet Kimberley Bradshaw , Head of Customer Content Experience

She has collaborated and written about hearing healthcare for several online publications.  By working closely with Hearing Aid UK audiologists, and experts, Kimberley develops the online content, so that the customer's experience is the best it can be. 

Kimberley's medical representation has allowed her to focus on the importance of hearing healthcare and explore the many ways in which hearing loss and its awareness can be improved.

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Common FAQs about hearing aids and hearing loss

Is this the best model for me?

If you are looking at this page then it is likely that an audiologist has suggested that you purchase this particular hearing aid, so is this the best model for you?

In general, any audiologist will always be recommending to you the model that best suits your needs. Here is a useful check list to make sure that is the case.

  • Audiologist level of knowledge. The audiologist you have seen will hopefully have a wide knowledge of all available hearing aids, however some will only be familiar with a small number of brands and therefore may not really be in a position to know which model is the best for you. It is OK to challenge their recommendation and ask them to justify why this particular brand is the one for you.
  • Do research. Read about the hearing aid that was recommended. Does it seem like it will suit your lifestyle? Does it have more or less features than you need? 
  • Be aware of sales targets. Many high street retailers have specific tie-ins to a particular manufacturer/brand. The hearing aid they have suggested may still be the correct one for you, but do your research so that you know why they might have recommended it.

If in doubt, feel free to give us a call. That's what we're here for.

Do I need one hearing aid or two?

If you have a significant hearing loss in both ears, you should be wearing two hearing aids. Here are the audiological reasons why:

Localisation. The brain decodes information from both ears and compares and contrasts them. By analysing the miniscule time delays as well as the difference in loudness of each sound reaching the ears, the person is able to accurately locate a sound source. Simply put, if you have better hearing on one side than the other, you can't accurately tell what direction sounds are coming from.

Less amplification required. A phenomena known as “binaural summation” means that the hearing aids can be set at a lower and more natural volume setting than than if you wore only one hearing aid.

Head shadow effect. High frequencies, the part of your hearing that gives clarity and meaning to speech sounds, cannot bend around your head. Only low frequencies can. Therefore if someone is talking on your unaided side you are likely to hear that they are speaking, but be unable to tell what they have said.

Noise reduction. The brain has it’s own built in noise reduction which is only really effective when it is receiving information from both ears. If only one ear is aided, even with the best hearing aid in the world, it will be difficult for you to hear in background noise as your brain is trying to retain all of the sounds (including background noise) rather than filtering it out.

Sound quality. We are designed to hear in stereo. Only hearing from one side sounds a lot less natural to us.

What are the benefits of rechargeable hearing aids?

For most people, the main benefit of a rechargeable hearing aid is simple convenience. We are used to plugging in our phones and other devices overnight for them to charge up. 

For anybody with poor dexterity or issues with their fingers, having a rechargeable aid makes a huge difference as normal hearing aid batteries are quite small and some people find them fiddly to change.

One downside is that if you forget to charge your hearing aid, then it is a problem that can't be instantly fixed. For most a 30 minute charge will get you at least two or three hours of hearing, but if you are the type of person who is likely to forget to plug them in regularly then you're probably better off with standard batteries.

Rechargeable aids are also a little bit bigger and are only available in behind the ear models.

Finally, just like with a mobile phone, the amount of charge you get on day one is not going to be the same as you get a few years down the line. Be sure to ask what the policy is with the manufacturer warranty when it comes to replacing the battery.


Are behind the ear aids better than in the ear aids?

For most people, the answer is yes. But it's never that simple.

The majority of hearing problems affect the high frequencies a lot more than the low ones. Therefore open fitting hearing aids sound a lot more natural and ones that block your ears up can make your own voice sound like you are talking with your head in a bucket. Therefore in-ear aids tend to be less natural.

However the true answer is we can't tell until we have had a look in your ears to assess the size of your ear canal, and until we have tested your hearing to see which frequencies are being affected.

People with wider ear canals tend to have more flexibility, also there are open fitting modular CIC hearing aids now that do not block your ears.

There is also the age old rule to consider, that a hearing aid will not help you if it's sat in the drawer gathering dust. If the only hearing aid you would be happy wearing is one that people can't see, then that's what you should get.

Most people can adapt to any type of hearing aid, as long as they know what to expect. Have an honest conversation with your audiologist as to what your needs are.

What are channels, and how many do I need?

Generally speaking, six or more. Unless it's none at all.

The number of channels a hearing aid has is often a simplistic way an audiologist will use to explain why one hearing aid is better than another, but channels are complex and it is really not that straightforward.

Hearing aids amplify sounds of different frequencies by different amounts. Most people have lost more high frequencies than low and therefore need more amplification in the high frequencies. The range of sounds you hear are split into frequency bands or channels and the hearing aids are set to provide the right amount of hearing at each frequency level.

Less than six channels and this cannot be done with much accuracy, so six is the magic number. However, a six channel aid is typically very basic with few other features and is suitable only for hearing a single speaker in a quiet room. The number of channels is not what you should be looking at, it's more the rest of the technology that comes with them.

As a final note, different manufacturers have different approaches. One method is not necessarily better than any other. For example some manufacturers have as many as 64 channels in their top aids. Most tend to have between 17 and 20. One manufacturer has no channels at all.

Where can I get the hearing aids covered?

Hearing aids are easily lost, misplaced or damaged and typically are one of the most expensive personal possessions an individual can own. We offer hearing aid warranty cover for £80 per year per aid.  Find out more here

How much does the hearing test cost?

All our audiologists use the very latest technology and provide the full range of tests to accurately measure your hearing for free.  Find out about what we offer all our customers here

Do home visits cost extra?

Hearing Aid UK offers all their customers free home visiting services and home visits for hearing aids - Including hearing tests, fittings, maintenance, check-ups and much more in the comfort of your own home and at your convenience.  Find out more information here

How come you're much cheaper than other places?

Here, at Hearing Aid UK, we are dedicated to offering low hearing aid prices. We achieve this by having no head office and low marketing costs.   Our hearing aid prices are amongst the lowest you will find anywhere in the world.

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