Does Presentation Two Hearing Damaging Elements Increase the Harmful Level or Cause Protection?

Noise and ototoxic drugs are among the most common causes of permanent hearing loss. It is commonly believed that simultaneous presentation of these harmful elements often non-linearly increases the level of hearing problems. However, careful selection of the presentation method of these ototoxic agents not only control the amount of damage, but may establish some levels of protection. This study tried to review the issue that under what circumstances simultaneous presentation of two damaging factors can cause protection and / or damage on hearing.
In this review, the latest articles were studied about ototoxic and noise-induced hearing damage during 1960- 2015 released in Science direct, Google scholar, springer, Magiran, scopus, Proquest and Pubmed databases on. Up to 125 searched articles, 59 was selected according a targeted selection method.
Presentation of hearing damaging element in low doses may activate the cellular protective systems in a limited timeframe. This process provides some cochlear resistance against more intense damaging elements by itself. A thorough understanding of this period will provide the possibility of providing appropriate therapeutic interventions.