Pharmacological strategies for preventing cochlear damage induced by noise trauma

Hearing loss induced by noise, as well as in combination with other environmental factors, is a significant health problem throughout the world. Although most structures in the inner ear can be harmed by excessive sound exposure, the sensory cells are the most vulnerable. Damage to the stereocilia bundle is often the first structural alteration noted. Once a large number of hair cells are lost, the nerve fibres to that region also degenerate resulting in an irreversible hearing loss. At present, the underlying mechanism for cochlear damage induced by noise is not fully understood. The failure of the adult peripheral auditory system to regenerate after injury is a major clinical problem. However, a number of experimental applications have recently become available and are effective in reducing the damaging effects of noise. Current experimental designs include strategies for protecting against injury and are primarily based on the fact that the metabolic state of the cochlea can determine the overall degree of hearing loss induced by noise. The purpose of the present article is to review the current literature dealing with strategies for protecting against noise trauma.