Hearing Problems, Dizziness, and Ototoxicity

Related: Dizziness, hearing loss, ototoxicity, tinnitus (ringing in the ears)

Hearing Loss

What Is Hearing Loss?

• Hearing loss occurs as a result of many different things. Hearing loss may be associated with age, or as a result of certain chemotherapy treatments or medications. By the age of 75, many have some sort of hearing loss.
• Many diseases can cause hearing loss. This includes Meniere's disease, an inner ear disease.
• There are many different types of hearing loss. They may include:
• Presbycusis - This is a word that means "hearing loss." This is the normal loss of hearing and sound detection that comes with age. If you have presbycusis, it becomes harder to hear people if there is background noise. High-pitched sounds also become "muffled."
• Sensory hearing loss - occurs when there is a more central problem. Certain diseases, infections, or damage to the cells that help you to hear sounds may cause this.
• Conduction hearing loss - occurs as a result of a blockage in your ear. This may be from earwax, infection, a foreign body, or tumor. This can be resolved by treating the cause of the hearing loss.

Common Medications That Cause Hearing Loss:

• Cisplatin chemotherapy
• Diuretics or "water pills" such as furosemide (Lasix^®), in high doses.
• Antibiotics, such as gentamycin, tobramycin or streptomycin.
• Ototoxicity is something that occurs after you have received medications that have caused you to lose your hearing, or feel dizzy. Ototoxicity following the use of certain medications may be due to a long-term exposure to these drugs. Your risk for developing ototoxicity increases as the drug accumulates in your body.
• Ototoxicity may also come from receiving high doses of an ototoxic drug at one time, which may damage certain cells in your inner ear. The hearing loss you experience as a result of medications may be irreversible.

Hearing Loss Symptoms:

• Most people notice that sounds are muffled or not as loud.
• Most types of hearing loss are progressive, and painless. It may be noticed on one side of your head, or both.
• There are some hereditary or family related causes of hearing loss. Know if hearing loss runs in your family.
• Some people may experience dizziness with a trouble hearing.
• Nausea, vomiting, dizziness and tinnitus (ringing in the ears), may be associated with hearing loss in some diseases.
• Hearing loss may be a symptom or sign of a serious problem. Notify your doctor if you experience any of the symptoms mentioned here.

How Is Hearing Loss Diagnosed?

• Your healthcare provider will usually, at first, take a complete health history from you. They will conduct a physical exam in their office. They will also look inside your inner ear, to see if there is an infection.
• With certain types of hearing loss, your healthcare provider may suggest that you see an audiologist, a professional who diagnoses, treats, and manages individuals with hearing loss or balance problems.
• A hearing test may be performed, to see if you have problems hearing at different levels or pitches (frequencies) of sound. Some people cannot hear high or low-pitched sounds, but may hear normal tones without any problem.

Things You Can Do To Minimise Hearing Loss:

• It is important to notify your healthcare provider if you notice any change in the hearing loss you are experiencing. Also, notify your healthcare provider if you have any loss of vision, dizziness, or if your symptoms become more severe, and do not improve.
• If your hearing loss is caused by a build-up of wax, there are many over the counter eardrops available for you to use. Discuss this with your healthcare provider.
• Tell people that you have trouble hearing sounds. Discuss ways for them to speak, so you can hear them more clearly. Some suggestions include:
• Tell them to speak slowly, and clearly, and not to shout. Shouting creates high-pitched sounds that could make it harder for you to hear what they are saying.
• Encourage the use of gestures, if you find it helpful.
• Many people have trouble hearing consonants. Tell them to enunciate, or pronounce their words more slowly and clearly.
• With severe hearing loss, lip reading and sign language may be helpful.
• Depending on the cause of your hearing loss, hearing aids may be useful to better your hearing. Hearing aids use an amplifier to pick up sound, and help to make sounds clearer. There are many forms of hearing aids available today. Seek assistance from a hearing aid specialist, who will help you to select the best kind of hearing aid, to suit your needs.
• Even with hearing aids, it may still be difficult for you to understand what people are saying to you. If you do not understand someone who is speaking to you, ask him or her to clarify what is being said. Tell them what parts of the sentence you were able to understand.
• If you have Meniere's disease, your doctor or healthcare provider may tell you to limit the amount of salt you eat in a day, and prescribe anti-nausea or anti-vertigo medications, along with a medication to help your body rid itself of salt and fluids. The goal is to decrease the pressure of your inner ear, and to control the dizziness you may be experiencing, in addition to the hearing loss.
• It is important to follow all the instructions your healthcare provides.
• Make sure to keep all appointments.
• Do not share your medications with anyone.

Drugs That May Be Prescribed By Your Doctor:

• There are few drugs that specifically treat hearing loss, if it is a result of aging, or due to damaged hearing cells in your ear. However, if there is a conductive hearing loss, antibiotics may be prescribed to treat an infection that may be blocking the transmission of sound to your ear.
• If your hearing loss is a result of drugs or medicines that you have received in the past, it is important to avoid these in the future, if possible. Be sure that you tell each of your health care providers about all of the medicines you are taking, including over-the-counter medications, vitamins, and herbal remedies. It is important to avoid the use of drugs that may cause further damage the cells in your ear.

If you believe you are suffering from hearing loss due to chemotherapy, the following guidelines discuss when to call your doctor or health care provider:

• If you develop any sudden severe ear pain.
• If you have a temperature greater than 100.5 F (38 C).
• If you experience vomiting more than 4-5 times in a 24 hour period.
• If you have a sudden loss of vision, or if you lose your hearing.
• If you fall down, or lose consciousness as a result of dizziness or hearing loss.
• Severe, uncontrolled nausea and vomiting, unrelieved by anti-nausea medications.
• If your symptoms worsen within 3 days of treatment.
• As always, notify your doctor or healthcare provider if you are concerned about any of the symptoms you are experiencing.

Note: We strongly encourage you to talk with your health care professional about your specific medical condition and treatments. The information contained in this website is meant to be helpful and educational, but is not a substitute for medical advice.

Additional resources for hearing problems:

Better Hearing Institute

515 King Street, Suite 420

Alexandria, VA 22314

800-EAR-WELL(327-9355)

http://www.betterhearing.org

The National Association of the Deaf

814 Thayer Ave.

Silver Spring, MD 20910-4500

Voice: 301-587-1788

TTY: 301-587-1789

http://www.nad.org

Self Help for Hard of Hearing People

7910 Woodmont Ave., Suite 1200

Bethesda, MD 20814

Voice: 301-657-2248

TTY: 301-657-2249

http://www.shhh.org

Note: We strongly encourage you to talk with your health care professional about your specific medical condition and treatments. The information contained in this website is meant to be helpful and educational, but is not a substitute for medical advice.