Visit our foundation to give a gift.
View Locations Near Me
Main Campus – Hartford
Connecticut Children’s – Waterbury
Urgent Care – Farmington
Specialty Care Center – Danbury
Connecticut Children’s Surgery Center at Farmington
Specialty Care Center – Fairfield
Search All Locations
Find a doctor
Find A Doctor
Request an Appointment
Amenities and Services
Who’s Who on Care Team
Getting Ready for Surgery
What to Expect—Picture Stories
Pay a Bill
Understanding the Different Fees
Pricing Transparency and Estimates
Raytheon Technologies Family Resource Center
Family Advisory Council
Legal Advocacy: Benefits, Education, Housing
Electronic Health Records
Share Your Story
Pay a Bill
Login to MyChart
Clinical Support Services Referrals
About the Network
Join the Network
Graduate Medical Education
Continuing Medical Education
MOC/Practice Quality Improvement
Educating Practices in the Community (EPIC)
Learning & Performance
Meet our Physician Relations Team
Request Medical Records
Join our Referring Provider Advisory Board
View our Physician Callback Standards
Read & Subscribe to Medical News
Register for Email Updates
Update Your Practice Information
Refer a Patient
Find and Print Health Info
Health Information For Parents
Ototoxicity is when a person develops hearing or balance problems due to a medicine. This can happen when someone is on a high dose of a drug that treats cancer, infections, or other illnesses.
When doctors find ototoxicity (oh-tuh-tok-SISS-ih-tee) early, they may be able to prevent it from getting worse. They also can help kids find the right treatments and therapies to manage problems the condition can cause.
Ototoxicity damages the inner ear. This part of the ear gets and sends sounds and controls balance. How much damage happens depends on:
The symptoms of ototoxicity can come on suddenly or show up over time.
Kids with ototoxicity might have:
Signs of hearing problems include:
Signs of balance problems include:
Kids with balance and vision problems might:
Nausea, vomiting, diarrhea, and changes in heart rate and blood pressure also can happen.
The most severe cases might affect vision. Kids may see images that bounce, jump around, or look blurry whenever they move their heads. This is called oscillopsia (ah-sih-LOP-see-uh).
There’s no way to test if a drug has caused ototoxicity. When a child has signs of a problem, the doctor may do hearing or balance tests. Often, they refer kids to an audiologist or otolaryngologist (ear, nose, and throat specialist, or ENT) for tests.
These tests can include:
Behavioral hearing tests. These involve watching a child’s response to sounds like calibrated speech and pure tones. Pure tones are the distinct pitches (frequencies) of sounds. The tests track the thresholds of hearing for various sounds.
Auditory brainstem response (ABR) test. Tiny earphones go in the ear canals and electrodes (small stickers) go on the scalp and behind the ears. The electrodes measure the responses from the auditory (hearing) nerve and other important auditory centers in the brain stem.
Otoacoustic emissions (OAE) test. A tiny probe goes in the ear canal, then many pulse-type sounds are introduced. An “echo” response from cells in the inner ear is recorded. A normal recording means that the inner ear amplifies sounds normally. This test, along with the ABR, is often used on newborns, babies, and young children.
Electronystagmogram (ENG). This test checks balance. A computer records involuntary eye movements as the child looks at a moving target or moves the head up and down, or after an injection of warm or cold water into the ear canal.
Posturography. This measures how well a child balances while standing on a stable or unstable platform.
Balance questionnaires. Kids old enough to describe a medical problem might write down their level of dizziness throughout the day as they do different things.
Research continues on ways to prevent ototoxicity or fix the damage it can cause. So far there’s no sure way to reverse it.
The good news is that sometimes the ear just needs time to heal. And some kids may have no further hearing or balance problems if they can stop taking the medicine that’s causing their symptoms.
Sometimes, doctors might change the dosage or the medicine. But that’s not always an option. Some drugs are key to fighting an infection or disease.
When switching to a different drug or reducing the dose isn’t possible, auditory or listening therapy and speech (lip) reading can help.
Kids with serious damage to the inner ear may need an amplification device, hearing aid, or cochlear implant:
Sometimes, the hearing loss is so severe that the most powerful hearing aids can’t amplify the sound enough. In those cases, doctors might recommend a cochlear implant:
Kids with balance problems will have balance therapy, or vestibular rehabilitation. They’ll work with a physical therapist or a vestibular therapist (someone trained in treating balance problems). Therapy might include exercises to help balance skills and coordination. These can involve:
Problems from ototoxicity aren’t always easy to notice. Kids with minimal hearing loss might have symptoms that don’t seem worth telling parents or doctors about. Some may not notice anything at all. Balance problems can be even tougher to spot, because kids have a harder time than adults recognizing and describing them.
So, before your child takes any new medicine, ask your doctor what side effects it might cause and what you should look for. To watch for problems with drugs that have a major ototoxicity risk, doctors may recommend that a child see:
Follow the testing schedule the doctor gives you, even if you don’t notice any change in hearing or balance. Regular, repeated testing is the best way to catch an ototoxic effect early.
The sooner doctors diagnose ototoxicity, the sooner a child’s treatment can begin.
In the youngest kids, it’s especially important to catch it early. To develop their speech and language skills, babies and toddlers need to hear voices and conversations clearly. Hearing problems in older kids can affect how they socialize, communicate with others, and do in school.
Balance problems can have a huge effect on kids of any age, and can put them at risk for dangerous falls.
If your child has hearing and/or balance problems while on high doses of medicines, talk to your doctor. Mention all symptoms, even if they don’t seem related. You might not think things like trouble walking or paying attention in school could have anything to do with the ears, but they might.
If you’re concerned about any medicine your child is taking, call your doctor. But don’t change the dose or stop giving your child a medicine without talking to your doctor first.
Most kids stumble and fall from time to time, but a child who continually loses his or her balance might have a balance disorder.
Hearing problems can be overcome if they’re caught early, so it’s important to get your child’s hearing screened early and checked regularly.
Cochlear implant can help many kids with severe hearing loss. Find out how they work and who can get them.
An auditory brainstem response (ABR) test is a safe and painless test that gives health care providers information about possible hearing loss.
Find out what the experts have to say.
Hearing may be the ears’ main job, but it’s not all they do. Learn all about the ears in this Body Basics article.
Working with a certified speech-language pathologist can help a child with speech or language difficulties.
A “popped” eardrum is more than just painful – it can sometimes lead to hearing loss. Learn about ruptured eardrums and how to prevent them.
Doctors often recommend physical therapy for kids who have been injured or have movement problems from an illness, disease, or disability. Learn more about PT.
Hearing loss happens when there is a problem with the ear, nerves connected to the ear, or the part of the brain that controls hearing. Someone who has hearing loss may be able to hear some sounds or nothing at all. To learn more, read this article for kids.
Hearing impairment occurs when there’s a problem with or damage to one or more parts of the ear. Find out its causes and what can be done to help correct it.
Knowing what’s “normal” and what’s not in speech and language development can help you figure out if you should be concerned or if your child is right on schedule.
Loud music can cause temporary and permanent hearing loss. Learn how to protect your ears so you won’t be saying, “Huh? What did you say?”
When a kid has trouble hearing, an audiologist can help. That’s a person specially trained to understand how hearing works and to help kids who don’t hear normally.
Want to hear what’s being said to you, by you, and about you? Find out how hearing aids help people with certain types of hearing loss.
What teachers should know about hearing impairments, and how to help students who have one succeed in school.
Note: All information is for educational purposes only. For specific medical advice, diagnoses, and treatment, consult your doctor.
© 1995-2020 KidsHealth®. All rights reserved.
Images provided by The Nemours Foundation, iStock, Getty Images, Veer, Shutterstock, and Clipart.com.