Cochlear Damage from Chlorhexidine in Guinea Pigs

Aursnes, Jarle

doi:10.3109/00016488109133262

Cited by 33 publications

(13 citation statements)

References 22 publications

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“…We are not aware of any reports of vestibular ototoxicity of topical alcohol, which is described in the present study. With respect to cochlear ototoxicity, previous studies 3,8 have demonstrated it after chlorhexidine application, as does the present study. Regarding alcohol, Morizono and Sikora 2 published a systematic study in the early 1980s on its potential cochlear ototoxicity.…”

Section: Discussionsupporting

confidence: 87%

Vestibular and Cochlear Ototoxicity of Topical Antiseptics Assessed by Evoked Potentials

Perez¹,

Freeman

Sohmer

et al. 2000

The Laryngoscope

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Objectives/Hypothesis: To evaluate and compare the effect of chlorhexidine gluconate, povidoneiodine, and alcohol-three antiseptics used before ear surgery-on the function of the vestibular and cochlear parts of the sand rat's inner ear. The assessment of damage is based on the recording of vestibular evoked potentials (VsEPs) and auditory brainstem response (ABR). Study Design: Prospective controlled animal study. Methods: Fat sand rats were randomly assigned to five different groups, each receiving topical application of a different agent: saline (control), gentamicin (ototoxic control), chlorhexidine, povidone-iodine, and alcohol. Right-side total labyrinthectomy was performed, and a polyethylene tube was inserted into the left (contralateral) middle ear. After baseline recordings were taken of VsEPs and ABR, each animal received five consecutive daily applications of the specific agent into the left middle ear. Three days after the fifth application, evoked potential recordings (VsEPs and ABRs) were repeated and compared with baseline measurements. Results: Administration of saline affected neither VsEPs nor ABR. In contrast, as expected, neither of these responses could be recorded after gentamicin application. After application of chlorhexidine all waves disappeared in all sand rats. Alcohol caused the waves to disappear in some of the animals only. Povidone-iodine did not affect VsEP recordings and had only a small effect on ABR. Conclusions: Chlorhexidine and alcohol had a clear toxic effect on the vestibular and cochlear function of the inner ear of the sand rat, whereas povidone-iodine did not. Thus, taking into consideration that this is an animal study, it appears that povidone-iodine might be preferable to the other agents tested in disinfecting ears with a perforated tympanic membrane.

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Section: Discussionsupporting

confidence: 87%

Vestibular and Cochlear Ototoxicity of Topical Antiseptics Assessed by Evoked Potentials

Perez¹,

Freeman

Sohmer

et al. 2000

The Laryngoscope

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“…4,5,7,8,16 Previous investigations have described the enhanced efficacy and clinical advantages of CHG in regional anesthesia, 17,18 whereas a limited number of animal studies have suggested concern regarding neurotoxicity. 14,15,19,20 This single-center, retrospective investigation in which all patients received skin antisepsis with CHG in isopropyl alcohol before spinal placement found an incidence of neurologic complications possibly related to the anesthetic technique (0.04%; 95% CI, 0.00%Y0.08%) to be similar to previous largescale estimates of neurologic complications after spinal anesthesia (0.03%Y0.06%). 21,22 Furthermore, none of the identified neurologic complications had a clinical course consistent with CHG neurotoxicity, namely, arachnoiditis, aseptic meningitis, or diffuse lumbar plexopathy.…”

Section: Discussionsupporting

confidence: 80%

“…Animal studies have demonstrated profound histologic and clinical evidence of neurotoxicity when high concentrations of CHG compounds are applied to the middle ear, anterior chamber of the eye, or directly into the neuraxis. 14,15,19,20 Although isolated anecdotal reports of CHG-related neurotoxicity are present in the lay press, there are no clinical reports to support this association in humans.…”

Section: Discussionmentioning

confidence: 99%

Neurologic Complications After Chlorhexidine Antisepsis for Spinal Anesthesia

Sviggum¹,

Jacob²,

Arendt³

et al. 2012

Regional Anesthesia and Pain Medicine

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The incidence of neurologic complications possibly associated with spinal anesthesia (0.04%) after CHG skin antisepsis is consistent with previous reports of neurologic complications after spinal anesthesia. These results support the hypothesis that CHG can be used for skin antisepsis before spinal placement without increasing the risk of neurologic complications attributed to the spinal anesthetic.

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“…Neurotoxicity has been reported for CHX [6][7][8][9]. Also PVP-I solution cannot be recommended for wound dressing of neural structures [10] and show reduced cell viability of fibroblasts in vitro [11] with probable delay in wound healing in the postoperative setting.…”

Section: Discussionmentioning

confidence: 95%