A 24-year-old woman taking high-dose aspirin for rheumatic fever develops bilateral tinnitus with a mild flat sensorineural hearing loss. Aspirin is stopped and within days her audiogram returns to normal. What is the mechanism of her hearing loss?
- A Irreversible destruction of outer hair cells in the basal turn
- B Reversible impairment of outer hair cell electromotility through inhibition of prestin-associated mechanics ✓
- C Ischaemic infarction of the stria vascularis
- D Demyelination of the eighth nerve at the internal auditory meatus
Correct answer: B. Reversible impairment of outer hair cell electromotility through inhibition of prestin-associated mechanics
Explanation
Salicylate ototoxicity is characteristically dose-dependent, bilateral, flat and fully reversible on stopping the drug. It acts by reversibly altering outer hair cell electromotility and cochlear blood flow rather than killing hair cells. Irreversible basal turn outer hair cell destruction describes aminoglycoside and cisplatin toxicity, which contrasts sharply with the benign course seen here.
Reference: Katzung's Basic and Clinical Pharmacology, 16th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.