The University of Arizona
Department of Surgery

Chemotherapy-Induced Hearing Loss

Chemotherapy drugs such as cisplatin are commonly used to treat several types of cancer. While chemotherapy has saved many lives, an unfortunate side effect can be ototoxicity (toxicity to the inner ear). Ototoxicity often causes permanent sensorineural hearing loss. The hearing loss starts in the ultrahigh frequencies (greater than 10000 Hz; above the range for speech perception), so it is not immediately obvious to the patient. As chemotherapy treatment continues, the hearing loss becomes more severe and affects a wider range of frequencies. Eventually, the speech range is affected and patients may require amplification with hearing aids after completing chemotherapy. Tinnitus may also occur. Lastly, chemotherapy may also affect the portion of the inner ear that is responsible for processing balance information, creating symptoms of dizziness or vertigo (feeling that the world is spinning when you are not moving).

While treating the cancer is of primary importance, it is also important to monitor hearing throughout treatment. Prior to starting chemotherapy, the following tests should be obtained: a baseline audiogram (hearing test) that includes the ultrahigh frequencies, Distortion Product Otoacoustic Emissions (to provide information about inner ear hair cell function) and possibly videonystagmography (to evaluate balance function). Follow-up hearing tests to monitor changes in hearing should be obtained at regular intervals during treatment at a schedule recommended by the audiologist. Additionally, consultation with a neurotologist (specialist of the inner ear), such as Dr. Jacob, is recommended. Intratympanic steroid injections may be recommended to prevent hearing loss or to try and recover function after a sudden hearing loss has been documented.

Why Us? 
  • The University of Arizona’s Department of Surgery/Division of Otolaryngology has recruited top-tier, fellowship-trained faculty to Tucson, bringing subspecialty expertise to the Southwest.
  • UA Otolaryngology faculty are experts in caring for common as well as complex ear, nose and throat diseases in children as well as adults.
  • Dr. Abraham Jacob, fellowship trained in Otology, Neurotology, and Cranial Base Surgery, is the first Neurotologist recruited to the Tucson area.  He is uniquely qualified to provide intratympanic treatments for sudden hearing loss associated with chemotherapy.
  • With the only university-based Otology/Neurotology program in the state of Arizona, Dr. Jacob’s active laboratory and clinical research program ensures that patients are offered only the most up-to-date treatment options.
  • Dr. Jacob has a specific interest in the prevention, diagnosis, treatment and rehabilitation of chemotherapy induced hearing loss. To this end, The University of Arizona Ear Institute maintains an active basic science research effort at The University of Arizona Cancer Canter, employing zebrafish and jellyfish models to better understand mechanisms underlying ototoxicity and to develop novel therapies for this clinical condition.

Patient Information