Fernandez Katharine A, Garinis Angela, Knight Kristin, Konrad-Martin Dawn, Morata Thais, Poling Gayla L, Reavis Kelly M, Sanchez Victoria A, Dreisbach Laura
National Institute on Deafness and Other Communication Disorders, NIH, Bethesda, MD.
Veterans Health Administration (VA) Rehabilitation Research and Development (RR&D), National Center for Rehabilitative Auditory Research, VA Portland Health Care System, OR.
Perspect ASHA Spec Interest Groups. 2024 Feb;9(1):113-123. doi: 10.1044/2023_persp-23-00153.
Ototoxic medications and chemical agents in the workplace can put individuals' hearing and vestibular health at risk for permanent injury. Proactive ototoxicity management (OtoM) strategies aim to minimize exposure, avoid onset of symptoms, provide ongoing monitoring, and manage auditory and vestibular changes as the clinical needs of the patient evolve. During a 2021 American Speech-Language-Hearing Association Special Interest Groups Open House, members of the International Ototoxicity Management Group discussed how best to integrate OtoM into routine clinical practice, what tools to use, and what special considerations need to be understood to best support patients and their families. Here, we have summarized their viewpoints to encourage widespread adoption of improved OtoM services for at-risk individuals.
The field of audiology needs to move to a place where we better understand the full extent of ototoxicity and can agree on expanding minimum guidelines that can be implemented more universally to mitigate, detect, and manage the damage from ototoxic exposures. Only recently has our field seen a therapeutic drug that can protect against ototoxicity; however, the population served is restricted only to children receiving treatment for nonmetastatic carcinoma. This is hopefully just the beginning of future therapeutic interventions to come, but, in the meantime, ototoxicity resulting from other medications in different patient populations and chemical agents persists.
职场中的耳毒性药物和化学制剂会使个人的听力和前庭健康面临永久性损伤的风险。积极的耳毒性管理（OtoM）策略旨在尽量减少接触、避免症状发作、提供持续监测，并随着患者临床需求的变化管理听觉和前庭变化。在2021年美国言语语言听力协会特别兴趣小组开放日期间，国际耳毒性管理小组的成员讨论了如何最好地将耳毒性管理纳入常规临床实践、使用哪些工具，以及需要理解哪些特殊注意事项以最好地支持患者及其家属。在此，我们总结了他们的观点，以鼓励为高危人群广泛采用改进的耳毒性管理服务。
听力学领域需要发展到一个我们能更好地全面了解耳毒性程度的阶段，并能就扩大可更广泛实施的最低指南达成一致，以减轻、检测和管理耳毒性暴露造成的损害。直到最近，我们这个领域才出现了一种能预防耳毒性的治疗药物；然而，受益人群仅限于接受非转移性癌治疗的儿童。这有望只是未来治疗干预的开端，但与此同时，不同患者群体中其他药物和化学制剂导致的耳毒性依然存在。
