A Clear Guide to Ototoxicity
Targeted Management of Ototoxicity
Ototoxicity refers to hearing or balance changes linked to certain medications and treatments. Many effects are mild, temporary, or monitored safely during care. An urgent audiovestibular medicine review is needed if hearing drops suddenly, tinnitus appears quickly, balance becomes unstable, symptoms worsen after dose changes, or neurological signs develop during or after treatment.
Comprehensive Care for Hearing, Vertigo & Balance
Comprehensive Care for Hearing, Vertigo & Balance
Medication-Related Hearing Loss
An Overview of Ototoxicity
Ototoxicity occurs when certain medications or medical treatments affect the inner ear, altering hearing, balance, or both. These effects occur because some drugs can interfere with delicate inner ear structures or nerve pathways involved in hearing and balance. Symptoms may include hearing changes, ringing in the ears, dizziness, or imbalance, and can develop gradually or over a short period.
Ototoxic effects vary depending on the medication, dose, treatment duration, and individual sensitivity. In many cases, changes are mild or reversible once treatment stops, while others require monitoring. Early identification allows clinicians to balance medical treatment needs with hearing and balance protection wherever possible.
OUR REVIEW
Trusted by Patients,
Proven by Results
EXCELLENT Based on 112 reviews Posted on Google Diana GranadosTrustindex verifies that the original source of the review is Google. I had an outstanding experience with Harley Street Vestibular Clinic and cannot recommend them highly enough. I developed severe vertigo while visiting London, and it was an incredibly frightening experience as it was my first time ever experiencing dizziness like that. I called the clinic on a Saturday, fully expecting to leave a voicemail since they were closed. To my surprise, the office manager, Preeti, returned my call that same day. I was so grateful. She was kind, reassuring, and went above and beyond to arrange an appointment for me first thing on Monday. From the moment I arrived, the entire team was professional, efficient, and compassionate. They understood how urgent and distressing my symptoms were and made every effort to see me as quickly as possible. The vestibular audiologist was exceptional—she took the time to thoroughly evaluate me, clearly explain everything she was doing, answer every one of my questions, and perform the appropriate treatment. I never felt rushed, and her expertise immediately gave me confidence that I was in the right hands. The clinic was incredibly responsive, organized, and genuinely caring throughout the entire process. They turned what was a very scary situation into one where I felt supported and well cared for. I am truly thankful to Preeti and the entire team for their kindness, professionalism, and outstanding care. If you are experiencing vertigo, dizziness, or balance problems, I would not hesitate to recommend Harley Street Vestibular Clinic.Posted on Google erika thomaziTrustindex verifies that the original source of the review is Google. Great positive experience!Posted on Google Carol BunyanTrustindex verifies that the original source of the review is Google. I could not fault my follow up appointment with Dr Aran and his team. He really does take the time to listen to your questions and really puts himself out to set you on the road to recovery . He genuinely seems interested in getting you better. I would highly recommend this practice.Posted on Google Ged RobinsonTrustindex verifies that the original source of the review is Google. Dr Benjamin Shaw was extremely thorough in his assessment of my recent attacks of vertigo. I have total confidence in his ability, once I have completed the further tests he has arranged at the Wimbledon clinic, to diagnose what is causing this issue with my health.Posted on Google Adrian LoweTrustindex verifies that the original source of the review is Google. I thoroughly recommend the Harley Street Audio Vestibular Clinic. I had an appointment with Dr Rudy Palaniappan who listened carefully to me, conducted a brilliant examination and explained everything to me with a future plan very clearly. I was really impressed!Posted on Google EvanTrustindex verifies that the original source of the review is Google. Dr Arun provided an excellent virtual consultation, took the time to understand symptoms and history and provided an initial diagnosis and treatment plan. It did not feel rushed or with any bias. Received comprehensive notes and summary promptly after the appointment. Would fully recommend.Posted on Google shahram zarafshanTrustindex verifies that the original source of the review is Google. Dr. Arun Pajaniappane is a brilliant and expert doctor. He was also incredibly friendly, making for a truly excellent experience.Posted on Google Vasile BaltacTrustindex verifies that the original source of the review is Google. I had an excellent consultation where both the doctor Arun Pajaniappane and the audiologist were highly professional, attentive, and genuinely responsive to my concerns. They listened carefully to my problems and explained everything clearly throughout the appointment. The procedures carried out were handled with great care and efficiency, which made me feel comfortable and well looked after. I very much appreciated their professionalism and patient-centred approach.Posted on Google Carol lansleyTrustindex verifies that the original source of the review is Google. My first consultation with Dr Arun Pajaniappane was an excellent experience. He listened carefully to me & did extensive tests to try to determine the correct diagnosis.
Pinpointing the Cause
Diagnosing Ototoxicity
When to Get Checked
Medication-related hearing or balance changes should never be ignored, especially when symptoms evolve during or after treatment. Early review helps prevent progression and supports safer ongoing care.
You should be assessed if hearing changes appear suddenly, tinnitus develops quickly, balance becomes unstable, symptoms worsen after changes in medication dose, or problems affect both ears. Urgent review is needed if hearing loss progresses rapidly, vertigo interferes with walking, neurological symptoms appear, or changes occur during chemotherapy or long-term antibiotic treatment.

How We Assess Ototoxicity
At Harley AVM, assessment begins with a focused review of medication exposure and symptom timing. We look at which drugs were used, dosage changes, treatment duration, and when hearing or balance symptoms appeared. We also consider medical history, concurrent treatments, and day-to-day impact to judge whether changes align with ototoxic effects and to guide safe next steps.
Investigations are selected based on presentation and may include pure-tone audiometry, speech audiometry, speech-in-noise testing, tympanometry, acoustic reflex threshold testing, eustachian tube function assessment, and otoacoustic emissions. Our senior audiovestibular consultant oversees the process, ensuring results are interpreted in the context of treatment and clinical risk.

Major Insurance Providers Accepted
DIAGNOSTIC TESTS
Specialist Tests to Assess Hearing, Balance and Inner Ear Health
Harley Street Specialists in Hearing, Dizziness & Balance
Specialist Care for Ototoxicity
Every Ototoxicity case is different. Your consultant will create a tailored plan to address your specific symptoms and lifestyle – when it started, how it affects your day, and which tests and treatments are right for you.