Ototoxicity is the pharmacological adverse reaction affecting the inner ear or auditory nerve, characterized by cochlear or vestibular dysfunction. The panorama of drug-induced hearing loss has widened over last few decades. Although ototoxic medications play an imperative role in modern medicine, they have the capacity to cause harm and lead to significant morbidity. Evidence has shown early detection of toxicity through prospective ototoxicity monitoring allows for consideration of treatment modifications to minimize or prevent permanent hearing loss and balance impairment. Although many ototoxicity monitoring protocols exist, their practicality is questionable due to several factors. Even though the existing protocols have proven to be effective, certain lacunae in practice have been encountered due to discrepancies among recommended protocols. Implementation of these protocols is mostly held back due to the incapacitated status of the patient. The choice of early ototoxicity identification techniques is still debatable due to variables such as high degree of sensitivity, specificity and reliability, less time consumption and less labour-intensive to the patient. Hence, the diagnosis and effective treatment of ototoxicity is challenging, even today. A stringent protocol with more practicality encompassing all elements aimed at profiling the effects of ototoxicity is greatly needed. This review describes an efficient application of ototoxicity monitoring and treatment protocol as an attempt to reduce the challenges in diagnosis and management of ototoxicity.

Background: To compare the frequency parameters of voice between children using cochlear implant (CI) and those with normal hearing and establishing a trend of development of voice characteristics across chronological and implant ages. Methods: The study included 87 children aged 12 to 72 months, with a mean age of 41 months. The subjects were divided into 2 groups: group 1 included 44 children using CIs, and group 2 included 43 children with normal hearing and age-appropriate speech and language characteristics. Both groups were categorized into 3 subgroups based on their chronological ages, group A (12-32 months), B (33-52 months), and C (53-72 months). The CI group (i.e., group 2) was further subdivided based on implant ages as group D (1-4 months), E (5-8 months), and F (9-12 months). Results: Comparison of vocal frequency parameters across chronological ages revealed a decline with increasing age in both groups; however, stability was not maintained in the CI group. There was a statistically significant difference in the vocal frequency parameters between normal hearing children and those with CI. Comparing across implant ages, there was a significant difference between groups D and F. Conclusion: For better communication abilities of individuals with CI, along with early implantation and rehabilitation, there is a need to also focus therapy on providing training on speech modulations, especially on voice characteristics .

This study reports an infant with a rare triad of congenital facial palsy, bilateral aural atresia, and middle ear malformations. We highlight the audiological test battery in detail that led to identifying this obscure cooccurrence in a 6-month-old infant. The challenges associated with identifying such rare conditions, especially in infants, can be overcome only by incorporating a meticulous and vigilant approach. The infant was subjected to a series of subjective and objective audiological evaluations, through which rare asymmetric facial grimaces were vigilantly observed. This observation warranted radiologic investigation, which confirmed the suspicion that the anomaly may not be restricted to auditory structures alone. As facial nerve anomalies were confirmed, diversified recommendations, including speech, language, and swallow evaluation, were made apart from the auditory management. Hence in cases of external ear anomalies, although rare, it is essential to rule out facial nerve abnormalities as they can be a concealed problem.