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How do aminoglycosides cause deafness....molecular level
In pathologic studies, severe aminoglycoside toxicity is associated with death of inner ear hair cells (Plogar et al, 2001). Doses that are not enough to kill hair cells may damage their motion sensitive hairs (sterocilia), making them unable to respond to motion, at least for some months.( Oei, Segenhout et al. 2004)

The mechanism of aminoglycoside ototoxicity remains unknown but it appears to involve both apoptotic (programmed cell death) pathways as well as formation of free radicals (for a review see Forge and Schacht, 2000). Some authors suggest that the mechanism of toxicity is through reduction of mitochondrial protein synthesis (Guan et al, 2000)

at: http://www.dizziness-and-balance.com/dis...xicity.htm
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