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Tinnitus is a kind of a disorder that leads to abnormal noise in the ears without any external stimuli. It is not a disease in itself but a symptom of some underlying disease. In some cases it can also occur as a side-effect of certain ototoxic medications.

Ototoxicity can be defined as the tendencies of some drugs or chemicals to affect inner ear structures, which include the vestibule, cochlea, and the semicircular canals. Ototoxic medications have the potential to cause hearing loss, tinnitus, dizziness and vertigo. The damage mostly starts from the inner row of outer hair cells and proceeds towards the other rows. Lastly, it reaches the inner hair cells.

In order for a drug to cause ototoxicity, it needs to reach the inner ear.

The intensity of ototoxicity depends upon the following factors:

• Concentration of the ototoxic drug in the blood,
• The time frame for which the drug has been used
• Individual vulnerability
• The use of some other ototoxic drugs
• If the renal function is unimpaired,
• A simultaneous noise exposure.

Ototoxicity that results from systemic drug therapies usually follows a prolonged therapy, high dosages or simultaneous renal failure, which affects drug excretion. Ototoxicity-induced hearing loss becomes evident first in high frequencies and then triggers tinnitus. After that it progressively affects the lower frequencies also and ultimately affects speech recognition.

Clinical toxicity that involves the cochleovestibular apparatus is evident in 2 – 4 % cases. The features of this ototoxicity include tinnitus, deafness, ataxia etc.

More than 180 compounds and their classes have been identified as being ototoxic. These drugs are not equally toxic and the effects of some of them are reversible. However, in most of the cases the deficit is more or less permanent. The best recognized and the most common agents of ototoxicity in veterinary medicine are amino glycoside antibiotics such as gentamicin. However, (oxy) tetracycline, polypeptides, erythromycin and chloramphenicold are ototoxic also.

Though the mechanism of toxicity is ambiguous but according to some medical scientists ototoxic antibiotics such as tetracycline trigger hearing loss and subsequent tinnitus by altering significant biochemical processes that may lead to the eventually death of the hair cells.

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