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Ototoxicity of gentamicin can be exploited to treat some individuals with Ménière's disease by destroying the inner ear, which stops the vertigo attacks but causes permanent deafness. [19] Due to the effects on mitochondria, certain inherited mitochondrial disorders result in increased sensitivity to the toxic effects of aminoglycosides.
Gentamicin can cause inner ear problems and kidney problems. [5] The inner ear problems can include problems with balance and hearing loss. [5] These problems may be permanent. [5] If used during pregnancy, it can cause harm to the developing fetus. [5] However, it appears to be safe for use during breastfeeding. [8]
Onset of ototoxicity ranges from taking a single dose to long-term usage of the drugs. [3] Signs and symptoms of ototoxicity include tinnitus, hearing loss, dizziness and nausea and/or vomiting. [3] The diagnosis of medicine-induced ototoxicity is challenging as it usually shows only mild symptoms in early stages.
Aminoglycoside antibiotics display bactericidal activity against Gram-negative aerobes and some anaerobic bacilli where resistance has not yet arisen but generally not against Gram-positive and anaerobic Gram-negative bacteria. [3] Streptomycin is the first-in-class aminoglycoside antibiotic.
Mitochondrial mutations can cause SNHL i.e. m.1555A>G, which makes the individual sensitive to the ototoxic effects of aminoglycoside antibiotics. [citation needed] The most common cause of recessive genetic congenital hearing impairment in developed countries is DFNB1, also known as Connexin 26 deafness or GJB2-related deafness.
Kidney damage and ototoxicity (which can lead to hearing loss) are the most important effects, occurring in 1–10% of users. [17] The nephro- and ototoxicity are thought to be due to aminoglycosides' tendency to accumulate in the kidneys and inner ear. [8] Diagram of the inner ear. Amikacin causes damage to the cochlea and vestibules.
Measures to prevent tinnitus include avoiding chronic or extended exposure to loud noise, and limiting exposure to ototoxic drugs and substances. [2] [15] If there is an underlying cause, treating that cause may lead to improvements. [3] Otherwise, typically, tinnitus management involves psychoeducation or counseling, such as talk therapy. [5]
Noise exposure is the cause of approximately half of all cases of hearing loss, causing some degree of problems in 5% of the population globally. [5] The National Institute for Occupational Safety and Health (NIOSH) recognizes that the majority of hearing loss is not due to age, but due to noise exposure.