Profound hearing loss associated with hydrocodone/acetaminophen abuse

Objectives: To describe profound hearing loss associated with hydrocodone o veruse and the successful rehabilitation of these patients with cochlear im plantation. Study Design: Retrospective review. Setting: A tertiary otologic referral center. Patients: Twelve patients with rapidly progressive hearing loss and a concu rrent history of hydrocodone overuse. Interventions: Comprehensive medical histories, physical findings, audiomet ric tests, and, in those patients undergoing cochlear implantation, postimp lantation performance data were reviewed. Main Outcome Measures: Clinical characteristics of hydrocodone-related hear ing loss and open set word and sentence performance in those patients under going cochlear implantation. Results: Hydrocodone overuse was associated with rapidly progressive sensor ineural hearing loss in 12 patients. In four patients the initial presentat ion was unilateral, and two, of the patients experienced vestibular symptom s. None of the 12 patients experienced improved thresholds after high-dose prednisone. Seven of the eight patients undergoing cochlear implantation ha ve demonstrated early success with their devices. Conclusions: Hydrocodone is frequently prescribed in combination with aceta minophen for the relief of pain and has a side effects profile similar to o ther medications in its class. Although not described previously, overuse o r abuse can be associated with a rapidly progressive sensorineural hearing loss. These patients can be successfully rehabilitated with cochlear implan tation.