Augmenting Inner Ear Oxidant Stress Defenses to Prevent and Reverse Noise-Induced Hearing Loss (NIHL)

INTRODUCTION: NIHL continues to be a costly operationally-relevant military disability despite advances in engineering and hearing conservation practices. A novel approach to the problem is to pharmacologically enhance the inner ear defenses against noise-induced oxidative stress, or to enhance the cochlea's ability to repair itself after noise-induced injury. METHODS: This paper reviews basic science and clinical study data regarding pharmacological protection and rescue from NIHL. CONCLUSIONS: There are clinically-available protective and rescue agents that will ameliorate NIHL while obviating some of the inherent limitations of engineering and mechanical hearing protection strategies. These agents await further clinical testing. Therapeutic use of these agents appears promising as a stand-alone solution for some noise exposures. In extremely noisy environments, they will augment the protection afforded by mechanical sound attenuation devices.