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Posted by Paul Ward
The text of a typical tinnitus-related internet site might start with a
statement about the prevalence of tinnitus followed by the statement
that it is generally associated with damage to the ear(s). It might
then proceed to say that the most common cause is noise exposure, with
ototoxic drugs not far down the list of potential causes. It then might
provide a very short list of ototoxic drugs. Many sites then go on to
make a statement such as "...in fact, about 200 drugs, both prescription
and non-prescription, are known to cause tinnitus". However, there is
never a statement regarding ototoxicity of these 200 (or so) drugs.
The reader (if paying attention) is then left to try to put these
statements together coherently. If tinnitus is associated with auditory
damage, then how can these supposedly non-ototoxic drugs result in
tinnitus?
Someone might tell me that these 200 drugs do not cause permanent
tinnitus but only temporary tinnitus. To this, I reply with two
responses:
1.) I presume the articles are talking about permanent tinnitus, since
nobody worries about tinnitus that's transient.
2.) Aspirin is widely reported to cause generally temporary ototoxicity
(and generally reversible tinnitus), and thus the label of otoxicity is
applied to temporarily ototoxic substances as well as those causing
irreversible damage. So if a substance is not ototoxic, if we are to
keep definitions consistent, it must not cause even temporary adverse
auditory effects.
So the questions are: Are there hundreds of common substances that
cause permanent tinnitus and if so, why aren't these substances
considered ototoxic if tinnitus is generally associated with auditory
damage?