Profound bilateral sensorineural hearing loss during gentamicin therapy

A case of profound bilateral sensorineural deafness occurring during gentamicin therapy is presented. Considerable recovery of the hearing in the right ear was observed but the left ear remained "dead". Electrocochleography confirmed the end-organ nature of the damage. Apart from the profound sudden deafness the unusual feature of this case was the total absence of vestibular effects. The ototoxic effects of gentamicin are discussed including the predisposing factors. While the incidence of ototoxicity with gentamicin is low (2-3%) this figure will only remain acceptable if the use of the drug is restricted to those patients who might die or suffer severe morbidity without it. The factors which make side-effects more likely to occur should always be borne in mind and due attention paid to the monitoring of renal function and serum antibiotic levels.