Department of Medical Microbiology, Immunology and Cell Biology, Southern Illinois University School of Medicine, PO Box 9626, Springfield, IL, 62704-9626, USA.
Callier Center for Communication Disorders, University of Texas at Dallas, 1966 Inwood Road, Dallas, TX, 75235, USA.
Drug Saf. 2018 May;41(5):451-464. doi: 10.1007/s40264-017-0629-8.
Ototoxicity diagnosis and management has historically been approached using a variety of methods. However, in recent years a consensus on useful and practical approaches has been developed through clinical guidelines of the American Speech Language Hearing Association, the American Academy of Audiology, and multiple clinical trials published in peer-reviewed literature. Some of the guidelines and approaches are used to detect and monitor ototoxicity, while others are used to grade adverse events. Some of the audiologic measures are primary, while others are adjunct measures and may be tailored to the specific needs of the patient or clinical trial. For some types of monitoring, such as drug-induced tinnitus or dizziness, validated paper survey instruments can be both sensitive and easy for fragile patients. This review addresses the characteristics of some of the most common clinical ototoxins and the most common methods for detecting and monitoring ototoxicity in clinical practice and clinical trials.
在过去，人们采用了多种方法来诊断和管理耳毒性。然而，近年来，通过美国言语语言听力协会、美国听力学学会和同行评议文献中发表的多项临床试验的临床指南，已经就有用且实用的方法达成了共识。其中一些指南和方法用于检测和监测耳毒性，而另一些则用于对不良事件进行分级。一些听力学测量是主要的，而另一些是辅助措施，可能根据患者或临床试验的具体需求进行调整。对于某些类型的监测，如药物引起的耳鸣或头晕，经过验证的纸质调查工具既敏感又便于脆弱的患者使用。本综述介绍了一些最常见的临床耳毒性药物的特征，以及在临床实践和临床试验中检测和监测耳毒性的最常见方法。
