Two of the most prevalent preventable causes of hearing loss are exposure to high-intensity noise and ototoxins. Between 10 and 40 million Americans show noise-induced hearing damage, which, untreated, is associated with depression, dementia, and cognitive decline. Meanwhile, ototoxins are found in platinum-based medications that are prescribed to thousands of Americans each year to treat cancer and/or cystic fibrosis.

At the 9th Biennial National Center for Rehabilitative Auditory Research (NCRAR) national conference, more than 150 clinicians, researchers, and students met to address diagnosis, treatment, and prevention of auditory disorders caused by noise damage or ototoxicity. As we’ve done in the past, the latest special issue of the American Journal of Audiology (AJA) showcases select papers highlighting the clinical implications of research presented at the NCRAR conference.

In their introduction, Special Issue Editors Angela C. Garinis, Dawn Konrad-Martin, and Naomi F. Bramhall divide the articles into three different categories:

  1. “Mechanisms” focuses on how ototoxins and noise exposure are associated with auditory damage.
  2. “Clinical Presentation” examines what this auditory damage looks like in a clinic.
  3. “Future Directions” highlights new methods of audiological monitoring and surveillance.

Mechanisms of Ototoxins and Noise Exposure

An important aspect of treating hearing loss caused by ototoxins and noise exposure is to understand how it works. Steyger outlines how two types of ototoxic medications damage the inner ear and also notes current research gaps in ototoxicity. Salvi and colleagues review changes to the hearing process after auditory damage caused by exposure to ototoxicity, showing other ways in which auditory damage manifests in a patient.

Two more articles focus on military service members, who are uniquely at risk to both ototoxins and noise exposure. Morata et al. review the dual risk of noise and jet fuel exposure in service members. Then, Griest-Hines et al. highlight the development and testing of a new questionnaire for service members and veterans to help determine risk factors such as exposure to loud noises or ototoxic solvents.

In the Clinic

Two articles look at aminoglycoside treatment for adults and children with cystic fibrosis—and how the medication can affect auditory function. Westman et al. focus on acoustic reflex growth, whereas Blankenship et al. discuss the impact of these treatments on speech perception.

Bramhall and colleagues look at a unique group of young veterans experiencing auditory distortion despite a normal audiogram and present a theory for this discrepancy. Then, Clark and colleagues highlight the real-world impacts of hearing loss and tinnitus, aural rehabilitation, and ototoxicity monitoring using patient perspectives.

Future Directions

The final two articles discuss auditory monitoring in patients taking ototoxic medication for cancer and cystic fibrosis. Garinis et al. provide some preliminary recommendations for monitoring hearing in patients with cystic fibrosis, and Konrad-Martin et al. present findings showing that people with cancer—although they are interested in monitoring their hearing—must have adequate access to this ototoxicity monitoring.

We hope that you enjoy this special issue of AJA! If you’d like to learn more about noise damage and ototoxicity, you can watch a video of Guest Editors Angela C. Garinis, Dawn Konrad-Martin, and Naomi F. Bramhall sharing their thoughts on the special issue below. We’d like to thank all three guest editors for their work putting together this issue of AJA. Check out the special issue or explore the individual articles below.

Explore the Issue

Blankenship, C. M., Hunter, L. L., Feeney, M. P., Cox, M., Bittinger, L., Garinis, A. C., Lin, L., McPhail, G., & Clancy, J. P. (2021). Functional impacts of aminoglycoside treatment on speech perception and extended high-frequency hearing loss in a pediatric cystic fibrosis cohort. American Journal of Audiology, 30(3S), 834–853.

Bramhall, N. F., McMillan, G. P., & Mashburn, A. N. (2021). Subclinical auditory dysfunction: Relationship between distortion product otoacoustic emissions and the audiogram. American Journal of Audiology, 30(3S), 854–869.

Clark, K. D., Garinis, A. C., & Konrad-Martin, D. (2021). Incorporating patient narratives to enhance audiological care and clinical research outcomes. American Journal of Audiology, 30(3S), 916–921.

Garinis, A. C., Konrad-Martin, D., & Bramhall, N. F. (2021). Ototoxicity and noise damage: From preclinical findings to audiological management. American Journal of Audiology, 30(3S), 797–799.

Garinis, A. C., Poling, G. L., Rubenstein, R. C., Konrad-Martin, D., Hullar, T. E., Baguley, D. M., Burrows, H. L., Chisholm, J. A., Custer, A., Dreisbach Hawe, L., Hunter, L. L., Marras, T. K., Ortiz, C. E., Petersen, L., Steyger, P. S., Winthrop, K., Zettner, E. M., Clark, K., Hungerford, M. . . . Brewer, C. C. (2021). Clinical considerations for routine auditory and vestibular monitoring in patients with cystic fibrosis. American Journal of Audiology, 30(3S), 800–809.

Griest-Hines, S. E., Bramhall, N. F., Reavis, K. M., Theodoroff, S. M., & Henry, J. A. (2021). Development and initial validation of the Lifetime Exposure to Noise and Solvents Questionnaire in U.S. service members and veterans. American Journal of Audiology, 30(3S), 810–824.

Konrad-Martin, D., O’Connell Bennett, K., Garinis, A., & McMillan, G. P. (2021). A randomized controlled trial using automated technology for improving ototoxicity monitoring in VA oncology patients. American Journal of Audiology, 30(3S), 870–886. 10.1044/2021_AJA-21-00032

Morata, T. C., Hungerford, M., & Konrad-Martin, D. (2021). Potential risks to hearing functions of service members from exposure to jet fuels. American Journal of Audiology, 30(3S), 922–927.

Salvi, R., Radziwon, K., Manohar, S., Auerbach, B., Ding, D., Liu, X., Lau, C., Chen, Y.-C., & Chen, G.-D. (2021). Review: Neural mechanisms of tinnitus and hyperacusis in acute drug-induced ototoxicity. Journal of Audiology, 30(3S), 901–915.

Steyger, P. S. (2021). Mechanisms of aminoglycoside- and cisplatin-induced ototoxicity. American Journal of Audiology, 30(3S), 887–900.

Westman, M. R., Putterman, D. B., Garinis, A. C., Hunter, L. L., & Feeney, M. P. (2021). Wideband acoustic reflex growth in adults with cystic fibrosis. American Journal of Audiology, 30(3S), 825–833.