drug-induced deafness
Introduction
Introduction to drug-induced deafness Drug-induced deafness refers to deafness caused by the use of certain drugs to treat diseases or human exposure to certain chemicals. Over the years, nearly a hundred ototoxic drugs have been discovered due to the widespread use of a large number of chemical drugs and antibiotics. In China, many ototoxic drugs are widely used and randomized, and some have even reached the level of abuse, as there are no laws and regulations prohibiting and restricting the use of ototoxic drugs. At present, drug-induced sputum has become the main cause of sputum in China. It should be highly valued by the whole society. basic knowledge The proportion of illness: 0.0005% Susceptible people: no special people Mode of infection: non-infectious Complications: speech and language development disorders headache, tinnitus, nausea and vomiting
Cause
Drug-induced deafness
Aminoglycoside antibiotic (35%):
Drug-induced deafness is caused by the consumption of drugs that are harmful to the body. Aminoglycoside antibiotics include streptomycin, gentamicin, kanamycin, novomycin, neomycin, tobramycin, lincomycin and the like.
Non-aminoglycoside antibiotics (26%):
Non-aminoglycoside antibiotics include chloramphenicol, zirconia, erythromycin, vancomycin, capreomycin, chunremycin, riudomycin, paromomycin, nisin, polymyxin B and so on.
Other drug factors (20%):
Salicylate: aspirin, phenacetin, APC, phenylbutazone, etc. Diuretics: furosemide, diuretic acid, mercury satari, etc. Antitumor drugs: cisplatin, nitrogen mustard, bleomycin, methotrexate, etc. Traditional Chinese medicine: aconitine, heavy metal salt (mercury, lead, arsenic, etc.). Others: quinine, chloroquine, propranolol, scorpion, insulin, iodine, chlorhexidine, etc.
Prevention
Drug-induced deafness prevention
1, ear drug poisoning is important in prevention, should strictly control the indications of various ear poisoning drugs to prevent abuse.
2. For patients with family history of poisoning and nephritis, aminoglycoside antibiotics should be avoided.
3, for infants, the elderly, pregnant women, patients with sensorineural hearing loss should avoid the use of ototoxic drugs.
4. Avoid the use of diuretics, anticancer drugs and aminoglycoside antibiotics.
5, in the application of ototoxic antibiotics, regular review of hearing, once the condition permits, should be discontinued immediately.
Complication
Drug-induced deafness complications Complications Speech and language development disorders headache, tinnitus, nausea and vomiting
Loss of language ability and other symptoms of poisoning.
Symptom
Drug-induced deafness symptoms common symptoms hearing loss deafness tinnitus otogenic vertigo dizziness
Drug-induced deafness is mainly caused by chronic poisoning of the auditory system, mainly deafness and tinnitus. Most of the deafness appeared 1 to 2 weeks after administration, gradually increased, and gradually stabilized after half a year. The deafness is bilaterally symmetrical, starting with high-frequency hearing loss, gradually expanding toward low frequencies, and a few people will continue to deteriorate to full paralysis. Tinnitus lasts for a long time, which aggravates the suffering of patients. Ototoxic drugs can also cause systemic damage such as liver, kidney, hematopoiesis, endocrine, and nervous system. Different drugs have their own characteristics. The aminoglycoside antibiotics cause sputum to appear as high frequency hearing loss above 4 kHz. Because the language frequency has not been affected, patients often do not feel deafness. At this time, it is possible to stop the drug immediately and take treatment measures. Stop the development of deafness. In addition, this class of drugs has obvious family susceptibility, and the amount of drug is extremely disproportionate to the degree of poisoning. A small amount of drug can cause irreversible severe spasm. Diuretic-induced convulsions are mostly reversible, and hearing recovery can be restored after early withdrawal, but renal dysfunction or combined with aminoglycoside antibiotics can cause permanent paralysis.
1. Some patients are often accompanied by headaches, dizziness, deafness and other symptoms. Patients usually take some ototoxic drugs, which may cause damage to the auditory nerve at the beginning. This may cause headaches. Symptoms of dizziness and tinnitus, sometimes squeaking in the ears, usually occur on both sides. If you can get timely garden ototoxic drugs at this time or take some treatment measures, you may be able to recover. This symptom can be aggravated if it is not treated promptly or if the drug is stopped.
2, there are some patients will have hearing loss, deafness and other symptoms, these symptoms are generally after hearing loss to appear in headaches, dizziness and tinnitus and other symptoms, the beginning of the patient is only hearing loss of high frequency sound, gradually For low-frequency sounds, there is also a drop in hearing. It is also possible that hearing loss and deafness occur during the course of medication, or it may occur months or years after withdrawal.
3, vertigo: In general, the vertigo of patients with deafness is more serious than the dizziness of the average person, the patient will feel the feeling of turning around when the disease occurs. As mentioned above, the anatomical auditory nerve is with the vestibular nerve. In general, the drug that can damage the auditory nerve can also damage the vestibular nerve. The patient is prone to dizziness, headache or vomiting.
Examine
Examination of drug-induced deafness
1. Hearing examination. Understand the nature, extent and dynamics of hearing loss.
2, vestibular function check. Perform an electromyogram check if necessary. The principle of nystagmus is that the human eye is similar to a battery. The cornea is positively charged relative to the retina, and the retina is negatively charged relative to the cornea, which means that a potential difference is formed between the cornea and the retina. When the eyeball is in the frontal position, the potential between the cornea and the retina is about 1 V, forming a weak electric field around the eyeball. When the eye moves, the electric field changes regularly, and the change of the electric field is the bioelectrical signal around the eyeball. This bioelectrical signal is collected and amplified approximately 20,000 times, and then graphically represented. This is the nystagmus.
Diagnosis
Diagnosis and identification of drug-induced deafness
It needs to be differentiated from conductive deafness and neurological deafness.
Neurological deafness refers to a syndrome in which the auditory nerve of the inner ear and the auditory center of the brain occur, and causes hearing loss and even hearing loss, often accompanied by deafness. In the case of neurological deafness, it actually refers to "sensory neuropathic paralysis", including lesions of the cochlea, as well as lesions of the auditory nerve, and even some of the lesions of the central nervous system, and not simply the problem of the auditory nerve. Different types of neurological deafness showed slight differences. The main manifestations were gradual hearing loss to unilateral or bilateral ear to varying degrees of deafness, accompanied by tinnitus and nausea in the ear. About half of the patients were accompanied by dizziness and nausea. And vomiting symptoms.
