INTRODUCTION

Audiologists perform diagnostic testing to determine the function of the ear for both hearing and balance. Patient histories include questions such as history of otosurgery, noise exposure, and ear infection; however, many audiologists may not think to ask about the use of possible ototoxic medications. Incidence of ototoxicity may be more common than previously thought, and the effect of these medications may be a contributing factor for patients with hearing loss and balance disorders. The use of ototoxic medications such as cisplatin and aminoglycosides are becoming more common; therefore, the possible effects that these medications may have on patients are becoming more common. Many times patients may be using these medications as lifesaving treatments, and they may not even be aware that hearing loss could be a possible side effect. As the use of ototoxic medications continues, the role of the audiologist will increase through monitoring the progression of hearing loss or vestibular dysfunction and also through rehabilitation with the use of amplification, cochlear implants, hearing-assistive technology, and compensatory strategies.

The subjects for the articles that are included in this edition of Seminars in Hearing came about as I, the guest editor, entered in to a large medical facility to establish an ototoxic monitoring program. Many of the articles are presented to answer questions either that I confronted or that were posed to me by other professionals who questioned the rationale for an ototoxic monitoring program or the potential for patient benefit from this program. The order of the articles presented follow the rationale of understanding the mechanism of ototoxicity as well as the possible uses of ototoxic medications. General guidelines are presented for ototoxic monitoring programs for the hearing and balance systems. The challenges of evaluating the pediatric patient also are discussed. Finally, the topic of how damage to the ear can be prevented through the use of medication is examined. The authors were chosen due to their expertise on their respective subjects. All of the authors are actively following patients who are affected by ototoxicity or are performing research on the subject. For these reasons, they were invited to participate in this edition.

The overall purpose of the edition is to provide increased awareness to clinicians regarding the subject of ototoxicity and to provide answers to possible questions that one may have when attempting to establish an ototoxic monitoring program. Audiologists in medical school or hospital settings may regularly see patients who are actively receiving ototoxic medication, and others may encounter patients receiving ototoxic medication only on an occasional basis. However, it is feasible that a large number of audiologists will find that they are seeing patients who have felt the impact of ototoxic medication during their lifetime.

I would not have been able to complete this issue of Seminars in Hearing without the assistance of many people. Catherine Palmer provided a great amount of guidance through this process and for that I am very grateful. I would like to thank Michael Valente for recommending me as a guest editor of Seminars in Hearing and for taking the time to advise and guide me through this process. He was always available for any questions that needed to be answered. I also would like to thank the authors of the articles for taking the time out of their lives to share information in their respective areas of expertise. It is greatly appreciated. Last, I would like to thank my wife, Tara, and son, Parker, for their support on this project.