Loop diuretics, including furosemide and ethacrynic acid, are capable of producing SNHL which is frequently reversible. The site of action is thought to be the stria vascularis, with inhibition of potassium chloride co-transport. Risk factors include renal insufficiency, use in neonates, intravenous administration, and co-administration with aminoglycosides. Cis -platinum is a relatively new cytoreductive agent used to treat a variety of malignancies. Morphological changes have not been noted in the vestibular organs.
Symptoms are frequently present at the onset of measurable hearing loss.
Risk factors for ototoxicity include renal insufficiency, intravenous bolus, co-administration with aminoglycosides, and increased cumulative doses. An audiogram should be obtained at the onset of therapy, before each successive dose, and with the onset of symptoms. Salycilates have been used for more than 100 years and have long been known to produce reversible hearing loss associated with tinnitus. The mechanism of action is thought to involve vasoconstriction of capillaries in the stria vascularis. Symptoms resolve following cessation of therapy.