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I would say the biggest adjustment has been factored in, though some uncertainty remains

Studies involving acoustic and chemical insults show that growth factors represent a compelling class of otoprotective compounds (Yagi et al., The HGF mimetic Dihexa is a synthetically derived Angiotensin IV analog that is blood-brain barrier permeable, stable, and orally bioavailable (McCoy et al., in vitro and in vivo , making a strong case for a small molecule activator of HGF/c-Met to confer a neuroprotective benefit (Zhang et al., The experimental value of zebrafish as an animal model for in vivo drug discovery has grown rapidly due to their ease of assessment, large clutch size, and ability to recapitulate human disease conditions (MacRae and Peterson, in vivo , demonstrating that otoprotective drug discovery in zebrafish translates to mammalian systems (Owens et al., In this study, we demonstrate that Dihexa protects lateral line hair cells from aminoglycoside ototoxicity

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Post-reconstitution storage is more restrictive

Other types are much less likely to spread and can often be treated with simple surgical excisions