Can Ototoxic Drugs Linger in the Ear?

[Telis]

Is this possible? I developed severe T after taking antibiotic ears drops. My ears are almost always in pain or blocked and my T and H has done nothing but progress since onset.

Almost a year later, is it possible this drug is still in my ears doing further damage? If it is, how do I purge it from my ears/system?

I am now taking NAC-1000mg a day...not sure if this will help or not.

Any opinions?

Thanks

 

[aylp]

Is this possible? I developed severe T after taking antibiotic ears drops. My ears are almost always in pain or blocked and my T and H has done nothing but progress since onset.

Almost a year later, is it possible this drug is still in my ears doing further damage? If it is, how do I purge it from my ears/system?

I am now taking NAC-1000mg a day...not sure if this will help or not.

Any opinions?

Thanks

Hi Telis,

First of all, it is cumbersome for ototoxic drugs to penetrate through your tympanic membrane to inner ear. But first tell me what was the material inside your antibiotic? For it to be ototoxic it has to end with -micin or -mycin. But tell me what it is, so that I can tell you if they could stay inside..

 

[Telis]

Hi Telis,

First of all, it is cumbersome for ototoxic drugs to penetrate through your tympanic membrane to inner ear. But first tell me what was the material inside your antibiotic? For it to be ototoxic it has to end with -micin or -mycin. But tell me what it is, so that I can tell you if they could stay inside..

Hi, I believe it was Ciprodex

 

[aylp]

Hmmm... Ciprofloxacin is not an aminoglycoside antibiotic - those that have well documented ototoxic effects. Aminoglycosides remain in the inner ear for at least a year and produce free radicals that further demolish the inner ear hair cells.

However, your antibiotic is presumably not ototoxic. Therefore its mechanism, and the reason behind your H and T are unclear.

 

[mick1987]

Hmmm... Ciprofloxacin is not an aminoglycoside antibiotic - those that have well documented ototoxic effects. Aminoglycosides remain in the inner ear for at least a year and produce free radicals that further demolish the inner ear hair cells.

However, your antibiotic is presumably not ototoxic. Therefore its mechanism, and the reason behind your H and T are unclear.

Looks like I dodged a bullet there! I was prescribed neomycin eardrops 4 months after getting noise induced tinnitus, it was only after using the drops for a week I found out neomycin is extremely toxic to the inner ear! But luckily for me it never worsened my T, I guess an intact eardrum saves you a whole lot of s**t!

 

[aylp]

Looks like I dodged a bullet there! I was prescribed neomycin eardrops 4 months after getting noise induced tinnitus, it was only after using the drops for a week I found out neomycin is extremely toxic to the inner ear! But luckily for me it never worsened my T, I guess an intact eardrum saves you a whole lot of s**t!

You were lucky, and you should give a piece of mind to the doctor who prescribed you this.

Anyway, even if your tympanic membrane did not do the job your middle ear is a large space that does not let it pass. 1.5 cm long deep space for the drop to reach to the round window and get defused in.

 

[Telis]

Hmmm... Ciprofloxacin is not an aminoglycoside antibiotic - those that have well documented ototoxic effects. Aminoglycosides remain in the inner ear for at least a year and produce free radicals that further demolish the inner ear hair cells.

However, your antibiotic is presumably not ototoxic. Therefore its mechanism, and the reason behind your H and T are unclear.

Well I was taking a pile of meds along with these drops...also I was doing the Valsalva method A LOT. I just remember my tinnitus going way way up after I took the drops. Maybe it was something else.

 

[aylp]

Well I was taking a pile of meds along with these drops...also I was doing the Valsalva method A LOT. I just remember my tinnitus going way way up after I took the drops. Maybe it was something else.

Myself got an intratympanic injection in the middle ear and that caused my T, H, fullness, and well my Right ear not feeling like an ear anymore... It was supposed to be a corticosteroid which in theory would be harmless... Many combinations may have led my inner ear become irritated; pressure and etc or it was mistakenly switched with an aminoglycoside-such as gentamicin-...

Taking up the drops, may have filled your middle ear which in return had led you hear the tinnitus more... Do you have any hearing loss at all?

 

[Telis]

Myself got an intratympanic injection in the middle ear and that caused my T, H, fullness, and well my Right ear not feeling like an ear anymore... It was supposed to be a corticosteroid which in theory would be harmless... Many combinations may have led my inner ear become irritated; pressure and etc or it was mistakenly switched with an aminoglycoside-such as gentamicin-...

Taking up the drops, may have filled your middle ear which in return had led you hear the tinnitus more... Do you have any hearing loss at all?

I don't have any hearing left above about 9500hz. Below that I have pretty good hearing for my age (40 yrs old)

 

[aylp]

I don't have any hearing left above about 9500hz

9500Hz? That's ultra high-frequency.

 

[Telis]

9500Hz? That's ultra high-frequency.

Yeah...my T is for the most part in these frequencies. But I can not hear any test tone above 9500 at all...nothing, even if I turn it up loud.

 

[aylp]

Yeah...my T is for the most part in these frequencies. But I can not hear any test tone above 9500 at all...nothing, even if I turn it up loud.

That's at least good news I have to say... I do not hear anything above and including 4kHz and the below is damaged too.

Since your hearing is intact, I do not believe you have anything related to Ototoxicity. Because most of them show themselves -except for Gentamicin- on the regular audiometry scale -0.25kHz to 8kHz -. Do you have any vestibular anomalies?

 

[Telis]

That's at least good news I have to say... I do not hear anything above and including 4kHz and the below is damaged too.

Since your hearing is intact, I do not believe you have anything related to Ototoxicity. Because most of them show themselves -except for Gentamicin- on the regular audiometry scale -0.25kHz to 8kHz -. Do you have any vestibular anomalies?

Sorry to hear about your hearing...yes at least I hear regular range well.

I have no idea to be honest. I had perfect ears before I somehow got my right ear totally blocked up( I believe from weight lifting). I had no tinnitus, just a blocked ear that was driving me crazy at the time. I used the Valsalva method almost obsessively trying to clear it to start. I believe this triggered the tinnitus (which only started in the blocked ear). I started with mild T, no H in the blocked ear. I thought at the time that I needed to clear it and that being blocked was causing the T. I went to the hospital a couple of times-was put on steroid nasal spay along with oral for 7 days. I was also put on ziplocone and adivan for sleeping problems related to the T. I was told my ears looked fine. A couple of days into the round of steroids, I woke up with T in my left ear as well. Keep in mind I'm still trying to clear my ear manually this entire time. I went back to the doc a couple of weeks later, he put me on the ear drops, this is when my T seemed to get bad. After this I also abruptly quit taking adivan, this seemed to add to the problem as well.

For the following months and up until now, things just slowly/gradually have gotten worse. I have massive ear pain now every day, and really bad H along with worsening T.

Anyway, long and complicated as you can see.

Thanks so much for your input.

Telis

 

[aylp]

This is (very) far fetched... But maybe you might have irritated your Stapedus or Tensor Timpani muscle, which reside in the middle ear and blocks the loud sounds reaching the inner ear. Their inflammation may also cause T and H.

To be able to understand if that is the case you might get your acoustic reflexes tested, and ask somebody to listen to your ear for T (I know this sounds like a scam, but there is something called objective Tinnitus, if the muscles are involved in this, occasionally a second person can hear it listening to your ear canal).

 

[Telis]

This is (very) far fetched... But maybe you might have irritated your Stapedus or Tensor Timpani muscle, which reside in the middle ear and blocks the loud sounds reaching the inner ear. Their inflammation may also cause T and H.

To be able to understand if that is the case you might get your acoustic reflexes tested, and ask somebody to listen to your ear for T (I know this sounds like a scam, but there is something called objective Tinnitus, if the muscles are involved in this, occasionally a second person can hear it listening to your ear canal).

Can objective T be high pitched like this though?

My ear muscles do do bizarre things like flutter and twitch at times.

 

[aylp]

I don't really know its pitch.. But just ask someone to listen to your ear in a quiet environment (I stress that even when the muscles are irritated, detecting objective tinnitus is very occasional)

 

[Sean]

Looks like I dodged a bullet there! I was prescribed neomycin eardrops 4 months after getting noise induced tinnitus, it was only after using the drops for a week I found out neomycin is extremely toxic to the inner ear! But luckily for me it never worsened my T, I guess an intact eardrum saves you a whole lot of s**t!

Hey Mick1987...you were really really struggling last year .
Did your T volume subside ?how are you doing now ? I believed some one bad closed iron door very loudly which had caused Spike .

 

[mick1987]

Hey Mick1987...you were really really struggling last year .
Did your T volume subside ?how are you doing now ? I believed some one bad closed iron door very loudly which had caused Spike .

Hi Sean, my tinnitus tone changed permanently, it went from a soft hissing noise to a harsher gas oven type noise with occasionally extra ringing on top. I think the volume lowered a little, during the spike last year I could hear it over the TV, nowadays I don't notice the T much in the day unless I'm in quiet rooms, apart from when I'm tired in the evening when the T rises, but I'm doing OK.

I do wear earplugs when walking the dog near traffic just in case of any loud suprises etc, I do regularly take magnesium because I read that can help protect the ear from loud noise.

So all in all I'm fine, as long as my T doesn't get any louder! Dental work coming up next month and I'm nervous, 3 fillings and teeth cleaning all on the same day.....Im still undecided if I'll risk it?

 

[Sean]

Hi Sean, my tinnitus tone changed permanently, it went from a soft hissing noise to a harsher gas oven type noise with occasionally extra ringing on top. I think the volume lowered a little, during the spike last year I could hear it over the TV, nowadays I don't notice the T much in the day unless I'm in quiet rooms, apart from when I'm tired in the evening when the T rises, but I'm doing OK.

I do wear earplugs when walking the dog near traffic just in case of any loud suprises etc, I do regularly take magnesium because I read that can help protect the ear from loud noise.

So all in all I'm fine, as long as my T doesn't get any louder! Dental work coming up next month and I'm nervous, 3 fillings and teeth cleaning all on the same day.....Im still undecided if I'll risk it?

I had my teeth cleaned and got 6 fills done 2 years or go ..no change in T !
I am glad you are doing better !!

 

[Larry OT]

@aylp
Damn, you a med school wiz doc? You know more than any doc I've ever seen.
I'm impressed.
What caused you hearing to go so bad?

 

[aylp]

@Larry OT

Thanks

My job is doing research basically. Thus, I know how to reach the relevant scientific articles... That's it. And, pity for us, there is not much stuff out there about the inner ear So I consumed almost all in 7 months after that awful thing happened to me.

I have some theories about my inner ear: I believe it is Meniere's+Some form of Ototoxicity; that I have gotten from a Transtympanic Injection.

 

[Larry OT]

@aylp
Your a bright guy. So sorry about your hearing and Problems.

Let me ask you, I had sudden hearing loss mainly low frequency in one ear.
This is after my onset of high pitch T by hearing loss and general music abuse, possible pain meds (low dose Percocet for other issue) 7 months ago.
I lost upper frequency as well but that came back not the below 125hz though, so now I have a low drone tinnitus in that ear as well.
Doc thought may be Meniere but no vertigo or fluids he can see.
Otoxtoxic issue?

 

[aylp]

@Larry OT

Thanks! Doesn't help much.. Many ENTs hate me, especially those whose last read paper is from 25 years ago.

I am not aware of any pain killer (except for aspirin) that can cause ototoxicity. Even if it did, it should not be permanent..

As far as I know, below 0.125 kHz there is no clinical significance.. Above and including 4kHz hearing loss is usually out of noise abuse or aminoglycoside antibiotics (Gentamicin, Tobramycin, etc.).

Classic Meniere's have a tent shaped (upside down V) audiometry in 0.25-8kHz range.

Can you send me an audiometry?

 

[Larry OT]

@aylp

ENT should hate you, you deserve their paycheck.
This audiometry is when loss happened on low end and hi on my good right ear.
The high end came back mostly. Not the low.
Thanks

 

[Larry OT]

I know that below 125hz is gone because I am an audio engineer and tested myself for those frequencies.
When you can, no worries.
It's after 2 am over the pond!

 

[aylp]

Your audiometries are very "Meniereistic".

I know tons of ENTs that would diagnose you with Meniere's without further analysis..

 

[aylp]

Get an Ecocg test: Electrocochleagrophy...

If they have come back, no rush... But next time you get something like this Ecocg may confirm Hydrops in your Cochlea..

 

[Larry OT]

Thanks, where do I send you my eNT's $.
Next time, I'll cut to the chase and jump out a window

 

[Larry OT]

@aylp
Nothing can be done for Hydrops, yes?

 

[DebInAustralia]

Ciprofloxacillin is ototoxic. I have t because of it.