Abstract
Ototoxicity refers to drug or chemical-induced damage to the inner ear, particularly the cochlea and vestibular structures, resulting in hearing loss and balance disorders. Cochleotoxicity, characterized by damage to the cochlear hair cells, results in sensorineural hearing loss, which may be temporary or permanent. Vestibulotoxicity, on the other hand, involves damage to the vestibular apparatus, resulting in symptoms such as dizziness, vertigo, and imbalance. This chapter examines the adverse effects of various therapeutic agents and environmental toxins on the auditory and vestibular systems. The importance of early detection and monitoring through audiological and vestibular function testing to mitigate the effects of ototoxic substances is also emphasized. The chapter continues with a detailed review of the primary ototoxic agents, including aminoglycoside antibiotics, chemotherapeutic agents such as cisplatin, and loop diuretics, highlighting their mechanisms of action and the underlying pathophysiological changes they cause. Strategies for prevention, including dosage adjustments, protective agents, and the development of less toxic drug alternatives, are also discussed. The chapter concludes with a discussion of the need for continued research into mechanisms of ototoxicity and protective interventions, with the goal of improving patient outcomes and quality of life.