Vestibulotoxicity: strategies for clinical diagnosis and rehabilitation

Objective: The purpose of this article is to discuss the most commonly prescribed vestibulotoxic medications and their impact on the vestibular system, to describe the clinical features of vestibular ototoxicity including symptoms reported by patients, and to describe assessment tools that may be used in a monitoring programme, including the functional impact of vestibular loss. Recently published data from a cohort of patients exposed to systemic aminoglycosides (AGS) are summarised, which highlight the importance of monitoring. The role and importance of vestibular rehabilitation in treating affected individuals is discussed. Design: This is a descriptive article. Study sample: Recently published data from 71 patients with cystic fibrosis with AGS exposure are summarised. Results: Recently published data from a cohort of patients exposed to systemic AGS reveal a high prevalence of vestibular system involvement. Conclusions: Evidence suggests that including assessment of vestibular function in a programme to monitor for ototoxic damage is essential. While suggestions about possible components of a monitoring programme are made, the need for further study in order to determine an ideal protocol for assessing vestibular system function during and following exposure to toxic agents is stressed.