OTOTOXICITY AND TOPICAL EARDROPS

Topical aminoglycoside ear drops are theoretically acknowledged to be potentially ototoxic when administered in the presence of a tympanic m embrane perforation. Although the development of clinical ototoxicity appears to be rare, nine well-documented and incontrovertible cases (1 2 ears in total) of iatrogenic topical vestibulotoxicity are presented , representing the largest series in the English language world litera ture to date. All patients were treated with the topical gentamicin-co ntaining ear drops Garasone(R), (betamethasone sodium phosphate and ge ntamicin sulphate) for prolonged periods. Toxicity was found to be pri marily vestibular rather than cochlear. Further review of five previou sly reported cases in addition to the findings from another four patie nts identified with topical ototoxicity are described. Although compen sation occurred in unilateral cases the disability in bilateral cases was typically severe and often resulted in litigation.