Ototoxicity

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Classification according to ICD-10
H91.0 Ototoxic hearing loss
ICD-10 online (WHO version 2019)

In medicine and pharmacology, ototoxicity refers to the (mostly undesirable) destructive effect of substances on the inner ear , in particular the sensory cells of the auditory and equilibrium organs, or the associated cranial nerves ( vestibulocochlear nerve ). Literally translated it means "ear toxicity".

mechanism

In most cases, such substances have a directly toxic effect on the cells of the sensory epithelium . Since these are ultimately nerve cells, the destruction is usually permanent and leads to hearing loss or deafness and balance disorders .

Ototoxins

Ototoxic drugs are some antibiotics ( aminoglycosides , glycopeptides ), platinum-containing cytostatics , diuretics ( furosemide ), chlorhexidine , quinine (as an anti-malarial agent ), salicylates ( acetylsalicylic acid ) and 4-hydroxybutanoic acid (GHB).

Other ototoxic chemicals are solvents ( alkylbenzenes , xylene , styrene , toluene , n- heptane , n- hexane , tri- and tetrachlorethylene ), lead , cadmium , mercury , arsenic , carbon disulfide , carbon monoxide , cyanide and γ-butyrolactone (GBL).

Medical application

As a palliative measure for Menière's disease , obliteration of the inner ear by introducing gentamicin can be useful in individual cases. This switches off the already severely dysfunctional inner ear.

prevention

In order to prevent "inner ear poisoning" with aminoglycosides (e.g. neomycin ), ear drops containing such agents should never be used in the ear canal if the eardrum could be perforated. Even very small amounts of liquid to the inner ear and in the hair cells of the cochlea , may result in irreparable loss of sensory hairs, with the result of hearing loss up to complete numbness and massive balance problems transgressed.

Hazard in the workplace

In many professions it is necessary to work with chemical substances known as ototoxins. Due to the lack of adequate information on the risk potential of many of these substances, there are hardly any measures to protect workers. However, experts warn against the combination of ototoxins and noise pollution in the workplace (construction, printing, paint shops, shipbuilding, agriculture, mining, etc.), as this increases the risk of hearing damage.

literature

  • J. Lautermann, J. Schacht, K. Jahnke: Aminoglycoside toxicity: pathomechanisms, clinical features and prevention options . In: ENT . tape 51 , 2003, p. 344-353 , doi : 10.1007 / s00106-003-0830-1 .
  • SD Stephens: Some historical aspects of ototoxicity. In: British Journal of Audiology. Volume 16, 1982, pp. 76-80.

Individual evidence

  1. ↑ Alphabetical directory for the ICD-10-WHO version 2019, volume 3. German Institute for Medical Documentation and Information (DIMDI), Cologne, 2019, p. 667
  2. ↑ Ototoxic drugs (Source: www.schwerhoerigen-netz.de) ( Memento from July 25, 2016 in the Internet Archive ) Retrieved July 25, 2016.
  3. ↑ Ernst Lehnhardt : The occupational damage of the ear . In: Archive Ear, Nose and Larynx Medicine . tape 185 , 1965, pp. 11–242 (Congress Report ).
  4. ↑ Aktories, Förstermann, Hofmann Starke: General and special pharmacology and toxicology, 10th edition, p. 823