Speech-in-noise difficulties in aminoglycoside ototoxicity reflects combined afferent and efferent dysfunction

OBJECTIVES: Patients with Cystic fibrosis (CF) often receive aminoglycosides (AGs) to manage recurrent pulmonary infections, placing them at risk for ototoxicity. Chronic AG use can lead to complex cochlear damage affecting inner and outer hair cells, the stria vascularis, and spiral ganglion neurons....

Audiologists monitoring patients on chronic aminoglycoside therapy should assess both afferent (hearing nerve) and efferent (brain-to-ear tuning) function, as speech-in-noise difficulties in this population reflect dual-pathway dysfunction beyond standard audiometric thresholds.

Identifying combined afferent and efferent auditory dysfunction in aminoglycoside ototoxicity expands the clinical monitoring framework beyond threshold audiometry and may prompt earlier, more targeted intervention.

1. 01Cystic fibrosis patients on chronic aminoglycoside antibiotics showed speech-in-noise difficulties.
2. 02Both afferent (ear-to-brain) and efferent (brain-to-ear) auditory pathways were found to be affected.
3. 03Standard hearing threshold tests may underestimate the functional impact of aminoglycoside ototoxicity.
4. 04Efferent dysfunction impairs the auditory system's ability to filter background noise.
5. 05Findings support broader ototoxicity monitoring beyond conventional pure-tone audiometry.

PMID

42173068

DOI

10.1016/j.heares.2026.109678.

Journal

Hearing Research

Publication type

research_article

Evidence level

3

Population

Cystic fibrosis patients on chronic aminoglycoside antibiotic therapy

Intervention

Assessment of afferent and efferent auditory function in the context of chronic aminoglycoside exposure