Targeted Topical Steroid Therapy in Sudden Sensorineural Hearing Loss

Kopke, Richard D.; Hoffer, Michael E.; Wester, Derin; O’Leary, Michael J.; Jackson, Ronald L.

doi:10.1097/00129492-200107000-00011

Cited by 159 publications

(182 citation statements)

References 15 publications

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“…In humans, although a variety of experimental catheter systems have been employed, the round window microcatheter from DURECT (RWμCath ™ , DURECT ™ , Co., Cupertino, USA) represents the best characterised system to date (10,13,27,48). In a recent nonconcurrent cohort study it was found that local continuous glucocorticoid delivery via the μCath in patients with acute severe or profound hearing loss and failure of standard systemic therapy showed a significant improvement in hearing compared to a historical control group without local treatment (16).…”

Section: Ii) Continuous or Discontinuous Drug Application Via Partly mentioning

confidence: 99%

“…Gentamicin is toxic to the sensory cells of the balance system and thereby suppresses the vertigo in these patients by partially ablating their vestibular system. There are also an increasing number of clinical reports related to the local application of glucocorticoids for acute hearing loss (9,10,11,12,13,14,15,16), glucocorticoids for Menière's disease (17,18,19,20) or for tinnitus (21,22,23,24,25). Other substances that have been tested in humans include local anaesthetics, neurotransmitters and neurotransmitter antagonists (26,27).…”

Section: Introductionmentioning

confidence: 99%

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Local inner-ear drug delivery and pharmacokinetics

Salt

Plontke

2005

Drug Discovery Today

161

123

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SummaryA number of drugs are in widespread clinical use for the treatment of inner ear disorders by applying them directly to the inner ear. Many new substances and drug delivery systems specific to the inner ear are under development, and in some cases are undergoing evaluations in animal experiments and in clinical studies. The pharmacokinetics of drugs in the inner ear, however, is not well defined and the field is plagued by technical problems in obtaining pure samples of the inner ear fluids for analysis. Nevertheless, a basic understanding of the mechanisms of drug dispersal in the inner ear has emerged that facilitates the design and interpretation of future pharmacokinetic studies.

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Section: Ii) Continuous or Discontinuous Drug Application Via Partly mentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Local inner-ear drug delivery and pharmacokinetics

Salt

Plontke

2005

Drug Discovery Today

161

123

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“…Despite the practicality in treating patients with a single intratympanic injection of steroids, Fig. 1 Comparison of pretreatment and posttreatment DPOAE amplitudes of group two animals (Mean ± SD 24 ± 4.6) this protocol may not be as optimal as a continuous infusion or multiple injections [22,23].…”

Section: Discussionmentioning

confidence: 99%

“…Sockalingam et al reported that the recording of DPOAE is a sensitive method for the evaluation of the functional state of OHCs and albino guinea pigs are the most sensitive animals in term of cisplatin ototoxicity, with alteration in DPOAE and damage to OHCs [23,24]. Evoked OAE, especially DPOAEs due to frequency specificity, were shown to be more sensitive for evaluating OHCs than were conventional audiometry, ultra high frequency audiometry, and auditory brainstem response [25].…”

Section: Discussionmentioning

confidence: 99%

Recovery of Hearing in Cisplatin-Induced Ototoxicity in the Guinea Pig with Intratympanic Dexamethasone

Çallı¹,

Pınar²,

Öncel³

et al. 2011

Indian J Otolaryngol Head Neck Surg

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The purpose of this study was to investigate the effectiveness of intratympanic dexamethasone injection as a therapeutic agent against cisplatin-induced ototoxicity. Animals were randomly divided into three groups. Group one received intraperitoneal cisplatin alone, group two, received intratympanic dexamethasone after cisplatin ototoxicity had been demonstrated. Group three, which is control group, received intratympanic dexamethasone.Then we made three measurements. First we measured the baseline distortion product otoacustic emission (DPOAEs) of all the guine pigs. Second we injected cisplatin intraperitoneal group one and two the same day. Third we measured DPOAEs after 72 h of group one and two. Moreover DPOAEs were measured at the end of the first and second week only in group two. Cochleae were harvested and processed for electron microscopy after then. Values of The DPOAEs amplitudes and signal-to-noise ratio (SNR) at 1-6 kHz frequencies for group 1 after the injections significantly decreased over those before injections (P \ 0.05). In group 3, there were no significant differences in DPOAE amplitude and SNR values When they are compare before and after their intratympanic dexamethasone injections (P [ 0.05). In group 2, the DPOAEs measurements were close to significance at the end of the second week (P = 0.056). Intratympanic dexamethasone injection did not cause any ototoxic effect. Although intratympanic dexamethasone did not reach the statistically significant results, the measurements were close to significance. Intratympanic dexamethasone might have a significant therapeutic effect after cisplatin ototoxicity with different dose and application regimens.

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“…Other authors have also described the use of intratympanic corticosteroids for the treatment of SHL. 9,[12][13][14][15][16][17][18][19][20][21][23][24][25][26][27] Although its efficacy alone has not been proved definitively, intratympanic corticosteroid therapy for SHL is becoming more widely used. The variability among treatment protocols for SHL also applies to intratympanic corticosteroid therapy.…”

Section: Intratympanic Therapymentioning

confidence: 99%

Metilprednisolona intratimpânica como terapia de resgate na surdez neurossensorial súbita

Raymundo¹,

Bahmad²,

Filho³

et al. 2010

Braz. j. otorhinolaryngol. (Impr.)

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Treat ment in sudden sensorineural hearing loss is a contentious issue, today, oral steroids are the most common choice and considered the best treatment option, but the use of intratympanic steroids has become an attractive alternative, especially in cases when systemic therapy fails, or to avoid the side effects of the systemic use of steroids. Aim:To describe the results of intratympanic methylprednisolone in idiopathic sudden sensorineural hearing loss after failure of oral prednisolone.Methods: In a prospective study fourteen patients with idiopathic sudden sensorineural hearing loss were treated with intratympanic methylprednisolone after failing in the treatment with systemic steroids. Pretreatment and post-treatment audiometric evaluations including pure tone average (PTA) and speech reception thresholds (SRT) were analyzed. Results:Ten from 14 patients treated with intra-tympanic methylprednisolone presented with hearing recovery > 20 dB in PTA or 20% in SRT. Conclusion:Three intratympanic injections of methylprednisolone improved pure-tone average or speech discrimination scores for a subset of sudden hearing loss subjects that failed to benefit from oral steroids. Braz J Otorhinolaryngol. 2010;76(4):499-509. ORIGINAL ARTICLE BJORL

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Targeted Topical Steroid Therapy in Sudden Sensorineural Hearing Loss

Cited by 159 publications

References 15 publications

Local inner-ear drug delivery and pharmacokinetics

Local inner-ear drug delivery and pharmacokinetics

Recovery of Hearing in Cisplatin-Induced Ototoxicity in the Guinea Pig with Intratympanic Dexamethasone

Metilprednisolona intratimpânica como terapia de resgate na surdez neurossensorial súbita

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