Opioid-Associated Hearing Loss: A 20-Year Review from the New Jersey Poison Center
- PDF / 361,972 Bytes
- 7 Pages / 595.276 x 790.866 pts Page_size
- 66 Downloads / 175 Views
ORIGINAL ARTICLE
Opioid-Associated Hearing Loss: A 20-Year Review from the New Jersey Poison Center Alexander M. Mozeika 1
&
Bruce E. Ruck 2 & Lewis S. Nelson 2,3 & Diane P. Calello 2,3
Received: 2 November 2019 / Revised: 6 May 2020 / Accepted: 8 May 2020 # American College of Medical Toxicology 2020
Abstract Background Opioid-associated ototoxicity is a known complication of opioid exposure, although the mechanism remains unclear. While historically most closely linked to heroin and oxycodone, evolving reports suggest that it may be a class effect of opioids. However, the evidence is limited to case reports. Methods A retrospective review of the New Jersey Poison Center records (ToxiCALL®) identified cases that included both hearing loss and recent opioid exposure between January 1, 1999, and September 21, 2018. Results Forty-one cases were identified, mean age 29.4 years, 51% (n = 21) were male. Reported heroin exposures comprised 51% (n = 22), 18 of which were heroin alone. The next most commonly cited opioids were oxycodone (n = 7), methadone, (n = 4), and tramadol (n = 3). Hearing loss was described as tinnitus in 24% of cases, hypoacusis in 37% of cases, deafness in 29% of cases, and mixed tinnitus/hypoacusis in 10% of cases. Only 34% (n = 14) of cases were associated with a potential hypoxic event. Of the cases that documented resolution data, 21% (n = 4 of 19) reported no improvement at time of hospital discharge. Discussion Opioid-associated ototoxicity appears to be a hypoxia-independent adverse effect since most of the reported cases did not involve a known contributory hypoxic event. It occurs with a wide array of opioids, which supports an opioid receptormediated mechanism. The ototoxic effect may be self-limited in many patients. Conclusion Opioid-associated ototoxicity was most commonly associated with heroin exposure and appeared independent of hypoxic events. Further investigation that clarifies the risk factors and long-term outcomes is needed. Keywords Opioid . Ototoxicity . Hearing . Toxicology . Poison center
Introduction Opioid-associated ototoxicity is a known complication of opioid exposure, but many questions remain regarding the pathophysiology, risk factors for development, and prognosis. It is described in association with many opioid agonists and often occurs in the context of chronic exposure [1]. Symptoms vary Supervising Editor: Katherine O'Donnell, MD * Alexander M. Mozeika [email protected] 1
Rutgers New Jersey Medical School, 140 Bergen Street, Suite G1600, Newark, NJ 07103, USA
2
New Jersey Poison Information and Education System, Newark, NJ, USA
3
Department of Emergency Medicine, Rutgers New Jersey Medical School, Newark, NJ, USA
from hypoacusis to overt deafness. While some patients may regain their hearing, in others the loss is permanent [2–4]. Most commonly, patients report a precipitous onset of unilateral or bilateral hearing loss, and audiometric testing demonstrates flat, profound sensorineural hearing loss with absent otoacoustic emissions and norm
Data Loading...
