![]() ![]() Given the current opioid epidemic, it is important for healthcare providers to understand which of these substances can result in ototoxicity, which otologic systems are affected (auditory and/or vestibular), and whether ototoxic effects are likely to be temporary or permanent. ![]() In fact, opioids and illicit drugs have been included in some publications listing ototoxic substances within the past decade, but not included in others. Accumulating case reports describe ototoxic effects resulting from misuse of opioids and illicit drugs, yet many healthcare professionals are not aware of the audiological and vestibular impacts of these substances. Commonly recognized ototoxic medications include aminoglycoside and macrolide antibiotics, loop diuretics, platinum-based chemotherapeutics, antimalarials, salicylates, and nonsteroidal anti-inflammatories. Ototoxicity is known to result from medications used to treat conditions such as cancer, infection, and kidney disease. Ototoxicity presents with a myriad of symptoms including hearing loss (HL), tinnitus, aural fullness, hyperacusis, imbalance, and/or vertigo. Conclusion: Practitioners who see patients for sudden or rapidly progressive HL or VL with no apparent cause should inquire about misuse of illicit drugs and opioids, particularly when the HL does not respond to steroid treatment. The literature is sparse regarding VL from illicit drugs and opioids. HL associated with opioids was typically sudden, bilateral, moderately severe to profound, and in most cases permanent. HL from cocaine/crack and heroin often presented with greatest losses in the mid-frequency range. This review shows that HL associated with amphetamines and cocaine was typically sudden, bilateral, and temporary. Results: Sixteen studies reported ototoxicity from illicit drugs, 27 from prescription opioids, and 1 was unspecified. A total of 44 articles were reviewed after excluding studies that were not available in English ( n = 3), only described acute effects in healthy cohorts ( n = 3) or only described general health aspects in a group on methadone maintenance ( n = 1). Search results yielded 51 articles published between 19. Search terms included variations of HL, VL, opioids, and illicit drugs. Most papers consisted of retrospective single-case reports, with few retrospective reviews or prospective cohort studies. Methods: Data were sourced from published papers reporting hearing loss (HL) and/or vestibular loss (VL) following misuse or overdose of opioids or illicit drugs. I don't understand the connection of all this to my motor repair.Background: The purpose of this review was to summarize the literature regarding the effects of opioids and illicit drugs on the auditory and vestibular systems. The 1/8 NPT plug over the orifice is stucker that stuck so I'm working up the courage to open up the MC Valve. So I now suspect a plugged orifice, or that the Manual Control Valve is not letting the oil thru to the Servo. NO PRESSURE in either one just a little dribble out. I measured the pressures at the "M4" and "M5" ports, which are the two paths to the Servo. One path move moves the Servo (& swash plate) one way while the other path drains & vice versa. It then, depending on the valve position, exits via one of two paths and on to the Servo at the Variable Displacement Pump. From there it goes thru a orifice and on to the Manual Control Valve. My pump has also an internal Charge Pump that is producing about 120 psi that I measured the "M3" port. When I slacken the -16 hose connections between the Variable Displacement Pump and the Hydraulic Motor, there's oil all over the place coming out, but the flow rate does not seem to change with control inputs. Quoting Removed, click Modern View to see ![]()
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