What's New in Ototoxicity Management?

Author:

Fernandez Katharine A.1ORCID,Garinis Angela23ORCID,Knight Kristin4,Konrad-Martin Dawn23,Morata Thais5,Poling Gayla L.6ORCID,Reavis Kelly M.27ORCID,Sanchez Victoria A.8ORCID,Dreisbach Laura9ORCID

Affiliation:

1. National Institute on Deafness and Other Communication Disorders, NIH, Bethesda, MD

2. Veterans Health Administration (VA) Rehabilitation Research and Development (RR&D), National Center for Rehabilitative Auditory Research, VA Portland Health Care System, OR

3. Department of Otolaryngology/Head and Neck Surgery, Oregon Health & Science University, Portland

4. Department of Pediatric Audiology, Child Development and Rehabilitation Center, Doernbecher Children's Hospital, Oregon Health & Science University, Portland

5. National Institute for Occupational Safety and Health, NIOSH, Cincinnati, OH

6. Department of Otolaryngology—Head and Neck Surgery, Mayo Clinic, Rochester, MN

7. OHSU-PSU School of Public Health, Oregon Health & Science University, Portland

8. Department of Otolaryngology—Head & Neck Surgery, University of South Florida, Tampa

9. School of Speech, Language, and Hearing Sciences, San Diego State University, CA

Abstract

Purpose: Ototoxic medications and chemical agents in the workplace can put individuals' hearing and vestibular health at risk for permanent injury. Proactive ototoxicity management (OtoM) strategies aim to minimize exposure, avoid onset of symptoms, provide ongoing monitoring, and manage auditory and vestibular changes as the clinical needs of the patient evolve. During a 2021 American Speech-Language-Hearing Association Special Interest Groups Open House, members of the International Ototoxicity Management Group discussed how best to integrate OtoM into routine clinical practice, what tools to use, and what special considerations need to be understood to best support patients and their families. Here, we have summarized their viewpoints to encourage widespread adoption of improved OtoM services for at-risk individuals. Conclusions: The field of audiology needs to move to a place where we better understand the full extent of ototoxicity and can agree on expanding minimum guidelines that can be implemented more universally to mitigate, detect, and manage the damage from ototoxic exposures. Only recently has our field seen a therapeutic drug that can protect against ototoxicity; however, the population served is restricted only to children receiving treatment for nonmetastatic carcinoma. This is hopefully just the beginning of future therapeutic interventions to come, but, in the meantime, ototoxicity resulting from other medications in different patient populations and chemical agents persists.

Publisher

American Speech Language Hearing Association

Subject

General Medicine

Reference84 articles.

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4. American Academy of Audiology. (2009). American Academy of Audiology's position statement and practice guidelines on ototoxicity monitoring. https://www.audiology.org/practice-guideline/position-statement-and-practice-guidelines-on-ototoxicity-monitoring/

5. American Conference of Governmental Industrial Hygienists. (2023). TLV/BEI guidelines. https://acgih.org/science/tlv-bei-guidelines/

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