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MANAGEMENT OF HEARING LOSS IN A PATIENT WITH MULTIDRUG-RESISTANT TUBERCULOSIS (MDR-TB)

I Gusti Ayu Mahaprani Danastri  -  Otorhinolaryngology and Head-Neck Surgery Department, Faculty of Medicine, Universitas Udayana, Denpasar, Indonesia, Indonesia
*Ketut Tadeus Max Nurcahya Pinatih  -  Otorhinolaryngology and Head-Neck Surgery Department, Faculty of Medicine, Universitas Udayana, Denpasar, Indonesia, Indonesia
Open Access Copyright 2026 I Gusti Ayu Mahaprani Danastri, Ketut Tadeus Max Nurcahya Pinatih
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

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Abstract

Background: Multidrug-resistant tuberculosis (MDR-TB) remains a major global health concern requiring prolonged treatment with second-line drugs. Aminoglycosides such as kanamycin are still widely used but carry a high risk of ototoxicity that may result in permanent hearing loss. Case Presentation: We report a 39-year-old female with rifampicin-resistant pulmonary tuberculosis who developed bilateral progressive hearing loss after two weeks of kanamycin therapy. Otoscopy and tympanometry were normal, but otoacoustic emission (OAE) showed bilateral refer results. Pure tone audiometry revealed severe bilateral sensorineural hearing loss. Kanamycin was discontinued and replaced by an injection-free regimen, and the patient was fitted with bilateral hearing aids to support communication. Conclusion: This case emphasizes the importance of baseline and regular audiological monitoring during MDR-TB treatment to detect early ototoxic effects and to allow prompt regimen modification to minimize permanent disability.

Keywords: aminoglycoside; audiology; hearing loss; ototoxicity; tuberculosis
Funding: Universitas Udayana

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