Update on Vestibulotoxicity: How can we Recognize and Prevent it

Abstract

 Drugs and other substances may cause irreversible damage to the inner ear. The term vestibulotoxicity refers to the toxic effect on the peripheral vestibular system and is usually caused by damage to the hair cells of the semicircular canals and otolithic organs. The devastating consequence of vestibulotoxicity is bilateral peripheral vestibular loss, including the phenomenon of oscillopsia. Parenterally administered streptomycin and gentamicin are the most common cause of vestibulotoxicity. There are few descriptions of other potentially vestibulotoxic drugs and substances, including cisplatin, solvents, organophosphate poisoning and others. Analysis of the literature shows weak evidence for true vestibulotoxicity. Unilateral vestibulotoxicity has been described after the use of ear drops containing gentamicin and, interestingly, also after parenteral use of gentamicin. We here present an updated review of vestibulotoxicity, and suggest the appropriate investigation for suspected unilateral and bilateral vestibular loss.