Medical Specialties

At the Center for Neurosciences, we work together across specialties to provide the best, most comprehensive approach to treatment.

Chemotherapy Induced Hearing Loss (Ototoxicity)

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 and chronic dizziness. The hearing loss starts in the ultra-high 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, a brain generated phantom perception similar to an auditory hallucination, 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 moving when you are not).

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 if hearing is actively deteriorating during chemotherapy. Intratympanic steroid injections may be recommended to prevent further hearing loss or to try and recover function after a sudden hearing loss has been documented.

Why Choose Us

  • Dr. Abraham Jacob, Medical Director for Ear & Hearing (E&H) at the Center for Neurosciences (CNS), is fellowship trained in Otology, Neurotology, and Cranial Base Surgery. He is the first and most experienced Neurotologist in Tucson.
  • Dr. Jacob was a founding member of the University of Arizona (UA) Department of Otolaryngology prior to his departure and transition to CNS. At UA, he was Vice Chair of ENT and held the rank of full Professor with Tenure. He has an international reputation as an expert for treating ear diseases.
  • Dr. Jacob transitioned his practice to the Center for Neurosciences in early 2017 as he felt that the new environment helped him to optimize delivery of personalized ear and lateral skull base care for his patients.
  • Dr. Jacob has a specific research interest in the prevention, diagnosis, treatment and rehabilitation of chemotherapy induced hearing loss.