Speech Language Pathology + Audiology

Protecting our patients' hearing & balance

A variety of medications, particularly those used for chemotherapy, can cause hearing loss and/or damage to the vestibular system (the portion of the inner ear that helps control balance). Such drugs are known as "ototoxic" or "vestibulotoxic" due to their negative effect on the structures of the ear.

The Tufts Medical Center Audiology Department offers an Ototoxicity Monitoring Service, where we monitor hearing and balance in children and adults who are receiving potentially ototoxic medications, such as:

• Cisplatin, carboplatin and other chemotherapy drugs
• Powerful antibiotics, including gentamicin
• Certain drugs used to treat sickle cell anemia, such as Desferal
• Radiation therapy, depending on the site of the treatment (such as cranial radiation) and the level of risk associated with the treatment

If left unmonitored, ototoxic medications can cause difficulties ranging from tinnitus to permanent, profound hearing loss. Our team's goal is to identify early signs of hearing loss so that your physician care team can adjust treatment (if possible) and better manage hearing loss and symptoms.

Long-term monitoring is also necessary if the treatment drug is platinum-based, because hearing loss can develop several years after completion of treatment.

Quality of life matters to us

Ototoxic monitoring consists of a comprehensive battery of hearing tests with careful monitoring of the high frequency range, where hearing loss is typically first identified. However, all testing is comprehensive and addresses a multitude of frequencies.

Before you begin treatment with a potentially ototoxic drug, your audiologist will perform a baseline hearing test. This provides information that we can reference after subsequent tests to determine if you or your child is having any hearing loss. Further monitoring follows on a scheduled basis so that we can detect any changes as early as possible. (For chemotherapy patients with cisplatin, we monitor following each cycle of treatment.)

What happens if we identify hearing loss? We share the data with your physician care team, who may decide if switching the medication, altering the dosage or making some other change to the treatment plan is appropriate. If you or your child is undergoing a life-saving treatment such as chemotherapy, however, your physician care team may not be able to make any changes. In such cases, we'll closely monitor for changes in hearing and address hearing loss as soon as possible if it is identified.

In cases where hearing loss is unavoidable, we can offer solutions to lessen its impact. For example, you or your child may be candidates for a hearing aid or assistive listening device. We also counsel on topics such as:

• Protecting against noise-induced hearing loss
• Using good communication strategies, such as maintaining face-to-face communication and minimizing background noise
• Making accommodations at home or in school for a child who has hearing loss

Hearing and balance problems from treatment with ototoxic or vestibulotoxic medications can be overwhelming, especially when faced with a difficult diagnosis. Our audiology team works hard to offer a monitoring service that is convenient for the patient and provides seamless care if hearing loss is identified. We're here to make sure hearing loss has a minimal impact on you or your child's quality of life.

We appreciate the importance of maintaining close relationships with referring physicians. While monitoring your patients, we'll forward all test results to you and be available to answer follow-up questions.