Hi Listmates,
Both of my children just completed Berard's (AIT) Auditory Integration
Therapy. At the conclusion of the 10 day therapy I was given a couple
pieces of advice that I would like to share with everyone.
1) Ototoxic Drugs & Chemicals should be avoided because they can cause
both temporary and permanent damage to the cilla in the ear. I have
included a rather lengthy piece that I found on the web that explains
this for those interested.
2) After AIT no headphones are allowed for any purpose. The direct
vibrations into the ear can cause damage. It is ok to put the headphones
behind the ear allowing the person to hear through the bone behind the
ear (I have not tried it).
I'm not endorsing the above, just passing along info from the
audiologist.
Sharon in Virginia

Balance and Hearing: At Risk From Drugs
Ototoxic Substances and Their Damage

Drugs
There are five drug groups whose members cause the majority of
ototoxicity cases diagnosed. These include the salicylates, quinines,
loop diuretics, aminoglycoside antibiotics, and some antineoplastics. In
addition, there is a subgroup of anti-tubercular drugs and a number of
"miscellaneous" drugs reported to be capable of causing ototoxicity.

Salicylates
In 1829, salicin, the active ingredient in all salicylates, was isolated
from the bark of the willow tree. Sodium salicylate was first used to
reduce a fever in 1875, and ototoxicity due to high-dose therapy was
noted in 1877.
Acetylsalicylic acid (ASA) is, perhaps, the most familiar of the
salicylates, but there are others including choline salicylate, magnesium
salicylate and sodium salicylate. Aspirin is the most commonly used drug
in the U.S. with as many as 20,000 thousand tons consumed yearly.
Salicylates are used as anti-inflammatory, anti-pyretic, analgesic, and
anti-thrombotic agents. Aspirin can be found in a number of
over-the-counter preparations including Alka-Seltzer, Ancasal, Astrin,
Cosprin, Easprin, Encaprin, Entrophen, Hiprin, Measurin, Novase, Empirin,
Aspergum, Supasa, Triaphen-10, ZORprin, Ecotrin, Anacin, and Arthritis
pain formula. Some other salicylate-containing drugs are Arthropan,
Tricosal, Trilisate, Doan's, Magan, Mobidin, Uracel, Amigesic, Diagen,
Disalcid, Mono-gesia, Arthra-G, Disalcid, Mono-gesic, Salflex, Salgesic,
and Salsitab.
Ototoxicity occurs in approximately 11 per 1,000 people receiving the
drug and has been seen with both the oral and topical routes.1 When
damage occurs, the hair cells of the cochlea are affected, beginning in
the base. Damage is temporary. Tinnitus (ear ringing), a symptom of
cochlear damage, does not usually begin until the ASA serum level is 19.6
mg/L or more. The therapeutic anti-inflammatory level is 150-300 mcg/ml.
Increased serum levels of salicylate can also result in salicylism, the
salicylate toxicity syndrome. Salicylism includes nausea, vomiting,
headache, tinnitus, hearing loss, mental dullness, confusion, quickened
pulse, and increased respirations.

Quinines
Quinine is found in the bark of the cinchona tree, which is indigenous to
South America. Europeans began using this bark in the 1630s to prevent
and treat malaria after observing its use by people native to the region.
While not as heavily used now, the quinines are still fairly common. They
can be found in prescription form, and over-the-counter, and in the tonic
water available at the grocery store. It is also used, unfortunately, to
"cut" heroin.
Quinines are used as anti-arrhythmic, anti-protozoal, anti-rheumatic, and
anti-nocturnal leg cramping agents. They are present in Legatrin,
Quin-260, Quin-amino, Quinamm, Quindan, Quiphile, Q-vel, quinidine
gluconate (Duraquin, Quinaglute Duratabs, Quinate, Quinatime,
Quin-Release), hydroxychloroquine (Plaquenil), chloroquine (Aralen),
quinidine polygalacturonate (Cardioquin) and quinidine sulfate
(Apo-Quinidine, CinQuin, Novoquinidin, Quinidex Exentabs, Quinora,
SK-Quinidine Sulfate).
Like the salicylates, quinine was recognized to cause hearing impairment
in the late 1800s. Quinine ototoxicity causes temporary damage to the
outer hair cells of the cochlea (possibly due to mild circulatory
impairment to the cochlea), and has also been associated with temporary
vestibular malfunction (possibly due to microemboli in the vestibular
circulation).
The incidence rate is unknown, but 20 percent of individuals receiving
200-300 mg daily will develop hearing loss. The U.S. Army found that
three out of four individuals drinking 1.6L of tonic water daily for two
weeks suffered significant vestibular dysfunction (reversible when tonic
water ingestion stopped). The therapeutic level is 2-6mcg/ml.
Also, like the salicylates, quinine can cause a separate intoxication
syndrome-cinchonism. Cinchonism includes deafness, vertigo, tinnitus,
headache, nausea, and visual loss.

Ototoxic substances
Salicylate
Ethacrynic Acid
Furosemide
Bumetanide
Amikacin
Gentamicin
Netilmicin
Tobramycin
Vancomycin
Minocycline
Capreomycin

Miscellaneous Drugs
There are other ototoxic drugs that do not fit into any of the above
groups. Erythromycin, vancomycin, and minocycline are three either
commonly used or regularly cause ototoxicity.
Erythromycin
Alcohol
Amphotericin B
Capreomycin
Carmustine
Chloramphenicol
Colistin
Deferoxamine
(I think I am missing a large chunck of info here)

Erythromycin, a macrolide antibiotic used to treat Legionnaire's disease,
can cause temporary cochlear damage that affects the speech frequencies
almost immediately. Vancomycin (Vancocin, Vancoled), a glycopeptide, also
causes cochlear damage but unlike erythromycin this effect is many times
permanent. Minocycline (Minocin, Vectrin), a tetracycline, causes a
temporary vestibular damage possibly in 30-90 percent of those taking it.


Chemicals
Agents described in the drugs section are commonly administered by nurses
in hospital settings. This section addresses chemicals encountered
coincidentally in the home and at work that should be avoided by patients
undergoing therapy with an ototoxic agent or those who have suffered
ototoxicity. Many chemicals have been identified as causing ototoxicity
in some individuals.
Ototoxic chemicals
Benzethonium
Bonain's solution (Cocaine, Phenol, and Thymol)
Butyl nitrite
Carbon disulfite
Carbon monoxide
Chlorhexidine
Formaldehyde gelatin
Hexane
Iodophor
Lead
Manganese
Mercury
Potassium bromate
Povidone iodine
Propylene glycol
Styrene
Tin
Toluene
Trichloroethylene
Xylene
All the chemicals listed are capable of causing cochlear-like damage (it
is not known if the damage is to the hair cells, cranial nerve VIII, or
the brain pathways). Only trichloroethylene, mercury, and manganese are
reported to also cause vestibular damage-type symptoms.
The following substances can contain one or more ototoxic chemicals:
grease remover, spot remover, rug cleaner, paint, varnish, thinner,
resin, insulation, room deodorizer, glue, auto emissions, spray paint,
organic solvent, insecticide, lacquer, adhesive, wood preservative,
fungicides, and liquid correction fluid. Exposure may also occur during
electroplating, shoe manufacturing, dry cleaning, cold vulcanization,
electronic battery manufacture, and polyvinyl chloride manufacturing.