[Deafness due to topical neomycin (author's transl)]

Area of Science:

• Ototoxic effects of antibiotics
• Clinical case studies in otolaryngology
• Wound management and antibiotic therapy

Background:

• Neomycin is typically used topically in combination antibiotics due to known oto- and nephrotoxicity.
• Topical antibiotic application requires careful dosage monitoring to prevent systemic absorption and toxicity.

Observation:

• A patient developed a dehiscent, infected wound after laryngectomy and neck dissection.
• The wound was treated daily with neomycin sulfate solution over three months.
• A total dosage of 30 gm of neomycin sulfate was administered.

Findings:

• The patient experienced complete deafness during the treatment period.
• The hearing loss was directly attributed to the topical neomycin sulfate application.
• High-dose topical neomycin can lead to irreversible ototoxicity.

Implications:

• Clinicians should exercise caution when using topical neomycin, especially in high doses or for prolonged periods.
• This case highlights the risk of ototoxicity even with topical administration, emphasizing the need for vigilant patient monitoring.
• Alternative wound care strategies may be necessary for patients at risk of hearing impairment.