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    Comment: While reportedly ototoxic, chemotherapeutic medications are rarely encountered as a source of vestibular dysfunction. Cisplatin is the most widely used anticancer drug currently and unfortunately, it is cochleotoxic, and may injure supporting cells (Ramirez-Camacho et al, 2004). The toxicity begins in the outer hair cells (Reavis et al, 2011) and for this reason DPOAE's have been suggested to be a reasonable method of detecting toxicity. The toxicity of cisplatin is synergistic with gentamicin, and high doses of cisplatin have been reported to cause total deafness. In animals, cisplatin ototoxicity is related to lipid peroxidation and the use of antioxidant agents such as vitamin E are protective (Rybak et al, 2000; Kalkanis et al, 2004). There are many chemotherapy agents which have no credible evidence for ototoxicity, and also many in whom there are single case reports of dubious significance. In general, drugs that are "broad" in their effects on the body would be expected to also have some ototoxicity. Ototoxic Medications - Dizziness-and- cialis effective Ototoxicity - Wikipedia Ciprofloxacin Use as a Topical Otic Preparation - JAMA Network
     
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