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Author: Admin | 2025-04-28
Outcome. Ear Hear. 2019 May 29. doi: 10.1097/AUD.0000000000000747. [Epub ahead of print] Protection Little is known about protection. Noise avoidance is likely important, but even here the story is complicated. Moderate amounts of noise may protect from extreme amounts of noise. Anti-oxidants protect partially from noise or toxins in several animal models. In theory, protection from oxidative stress might be obtained by prevention of reactive oxygen species, neutralization of toxic products, and blockage of the apoptosis pathway. Toxic waste products can be neutralized with glutathione and derivatives (Rybak et al, 2000). Vitamin E may protect against cisplatin ototoxicity(Kalkanis, Whitworth et al. 2004). Apoptosis can be blocked using capsase inhibitors. Intratympanic dexamethasone has been reported to protect from cis-platin ototoxicity in rodents and humans (Murphy and Daniel, 2011; Marshak et al, 2014). Doglan et al (2016) reported that misoprotol can protect from cisplatin-induced ototoxicity (in rats). Wu et al suggested that statins may reduce the risk of hearing loss (2024) At this writing, all of these approaches are investigational and are not being used clinically. Most also require delivery systems that go directly into the inner ear, and are therefore impractical for clinical use (Van de Water and others, ARO abstracts, 1999, #21). Grading of ototoxicity. Recently effort has been put towards developing methods of grading ototoxicity that are clinically relevant, and in particular, related to hearing aid needs (Chang, 2011). Far more thought is needed about this.References: Chang KW.Clinically accurate assessment and grading of ototoxicity. Laryngoscope. 2011 Dec;121(12):2649-57. doi: 10.1002/lary.22376. Doğan M1,2, Polat H3, Yaşar M3, Kaya A3, Bayram A3, Şenel F4, Özcan İ3.Protective role of misoprostol against cisplatin-induced ototoxicity. Eur Arch Otorhinolaryngol. 2016 Apr 6. [Epub ahead of print] Kalkanis, J. G., C. Whitworth, et al. (2004). "Vitamin E reduces cisplatin ototoxicity." Laryngoscope114(3): 538-42. Murphy D, Daniel SJ. Intratympanic Dexamethasone to Prevent Cisplatin Ototoxicity: A Guinea Pig Model. Otolaryngol Head Neck Surg. 2011 Apr 26. [Epub ahead of print] Rybak LP, Husain K, Morris C, Whitworth C, Somani S. Effect of protective agents against cisplatin ototoxicity. Am J Otol 21:513-520, 2000 Marshak T1, Steiner M, Kaminer M, Levy L,
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