The problem of ototoxic side effects is reported to be more critical in developing countries, where highly effective and low cost drugs are more easily prescribed without adequate monitoring (Arslan et al, 1999).

The elderly and patients receiving potentially ototoxic medication (chemotherapeutic agents, second-line antituberculosis regimens and antiretroviral therapy) are at high risk of developing deafness.

No therapy is currently available to reverse the serious damage that can be caused by ototoxic drugs, such as permanent hearing loss and balance disorders.

One source of acquired hearing loss is the use of ototoxic medications for the treatment of cancer.

(4) The introduction of quinolone eardrops in 1998 heralded a new era in ototopic treatment, largely replacing gentamycin-containing drops with their well-known ototoxic potential.

The cases with a history of chronic infection, ear surgery, diabetes mellitus, renal failure, otolaryngology abnormalities (micro-vascular free flap reconstruction, lip-palate abnormalities), ototoxic drug use, acoustic and head traumas were eliminated from the study.

(1983) were the first to suggest that organic solvents also present an ototoxic effect in animal studies.

Family history(*) Congenital infections (TORCH) Craniofacial anomalies Hypcrbilirubinemia requiring transfusion Ototoxic medication Birthweight < 1500 g Bacterial meningitis Apgar scores of 0-4 at 1 min, 0-6 at 5 min Mechanical ventilation for at least 5 days Syndrome associated with hearing loss (*) Childhood sensorineural hearing loss.

Uremic toxins, electrolyte abnormalities, vitamin D deficiency, ototoxic drugs for CKD treatment, or HD itself might affect the auditory function.

Mammalian HCs loss by noise trauma, ototoxic drugs, or infection is a major cause of deafness [1].

The risk factors according to JCIH are family history, prematurity, birth asphyxia, hyperbilirubinaemia at serum levels requiring any intervention, in-utero infections, craniofacial anomalies, birth weight <1500 g, ototoxic medications and postnatal asphyxia.