Case report: Naproxen-associated sudden sensorineural hearing loss

Military Medicine,  Nov 1998  by McKinnon, Brian J,  Lassen, Lorenz F

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Conclusions

That salicylates and NSAIDs can cause reversible sensorineural hearing loss is well known to most health care providers. What is not as well appreciated is that NSAID-induced sensorineural hearing loss can be permanent. Cofactors may include renal disease and autoimmune disorders. Clearly, the prescribing health care provider should ask the patient about such conditions and warn of hearing loss as a potential side effect.

That the first symptom of sensorineural hearing loss from NSAIDs is tinnitus should be communicated to the patient. The patient should be told to immediately discontinue NSAIDs and seek help should tinnitus or distorted hearing develop.

References

1. Clinical Pharmacology. Gold Standard Multimedia, 1997. 2. Chapman P: Naproxen and sudden hearing loss. J Laryngol Otol 1982; 96: 163-6. 3. Jung TI, Choi DC, Park YS, Lee CS, Rhee CK: Ototoxicity of salicylate, nonsteroldal antiinflammatory drugs, and quinine. Otolaryngol Clin North Am 1993; 26: 791-810.

4. Brien JA: Ototoxicity associated with salicylates: a brief review. Drug Saf 1993; 9: 143-8.

Seligmann H, Goldsher M, Fradis M, Ben-David J, Podoshin L: Drug-induced tinnitus and other hearing disorders. Drug Saf 1996; 14: 198-212. Jung IT, Baer W, Park YM, Woo HY, Rozehnal S, Miller SK: Effect of round window membrane application of salicylate and indomethacin on hearing and levels of arachidonic acid metabolites in perilymph. Acta Oto-Laryngol Suppl 1992; 493: 81-7.

Vernick DM, Kelly JH: Sudden hearing loss associated with piroxicam. Am J Otol 1986; 7: 97-8.

Schaab KC, Setzen G, Dickinson ET: Acute sensorineural hearing loss following intravenous ketoralac administration. J Emerg Med 1995;13: 509-13. Kastanioudakis I, Moustopoulos MH, Drosos AA, Tsiakou E, Danielidis V, Skevas A: Inner ear involvement in rheumatoid arthritis: a prospective clinical study. J laryngol Otol 1995; 109: 713-8.

*Department of Otolaryngology-Head and Neck Surgery, Naval Medical Center, Portsmouth, VA 23708-2197.

t Department of Otolaryngology-Head and Neck Surgery. Eastern Virginia Medical School, Norfolk, VA 23507-1912.

The views expressed in this article are those of the authors and do not reflect the official policy or position of the Department of the Navy, the Department of Defense, or the U.S. Government.

Reprint requests: LCDR Brian J. McKinnon, MC USN, Naval Medical Center, Portsmouth, Department of Otolaryngology-Head and Neck Surgery (Code 0609), 630 John Paul Jones Circle, Portsmouth, VA 23708-2197.

This manuscript was received for review in December 1997 and was accepted for publication in March 1998.

Copyright Association of Military Surgeons of the U.S. Nov 1998
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