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Arne Liebau, Olivia Pogorzelski, Alec N Salt, Stefan K Plontke
OBJECTIVE: Controlled and uncontrolled studies with primary intratympanic or combined intratympanic and systemic application of glucocorticosteroids for idiopathic sudden hearing loss were analyzed by means of a meta-analysis in an attempt to establish optimal local drug delivery protocols. STUDY DESIGN: A total of 25 studies with 28 treatment groups between January 2000 and June 2014 were selected that adequately described drug delivery protocols. Cochlear drug levels were calculated by a validated computer model of drug dispersion in the inner ear fluids based on the concentration and volume of glucocorticoids applied, the time the drug remained in the middle ear, and the specific timing of injections...
October 21, 2016: Otology & Neurotology
S K Plontke, G Götze, T Rahne, A Liebau
Local drug application to the inner ear offers a number of advantages over systemic delivery. Local drug therapy currently encompasses extracochlear administration (intratympanic injection); intracochlear administration, particularly for gene and stem cell therapy; as well as various combinations with auditory neurosensory prostheses, either evaluated in preclinical or clinical studies, or off-label. To improve rehabilitation with cochlear implants (CI), one focus is the development of drug-releasing electrode carriers, e...
October 18, 2016: HNO
Yuan Zhang, Yong-Hua Cui, Ying Hu, Zhong-Yao Mao, Qiu-Xia Wang, Chu Pan, Ai-Guo Liu
The purpose of the study was to observe changes in endolymphatic hydrops by using intratympanic injection of gadolinium and magnetic resonance imaging (MRI) before and after endolymphatic sac surgery in patients with unilateral Meniere's disease. Thirteen patients with unilateral Meniere's disease undergoing endolymphatic sac surgery were retrospectively and prospectively analyzed. Three-dimensional fluid-attenuated inversion recovery or three-dimensional real inversion recovery MRI was performed 24 h after an intratympanic injection of gadolinium to grade the presence of endolymphatic hydrops...
October 2016: Journal of Huazhong University of Science and Technology. Medical Sciences
Michael C Topf, David W Hsu, Douglas R Adams, Tingting Zhan, Stanley Pelosi, Thomas O Willcox, Brian McGettigan, Kyle W Fisher
PURPOSE: To determine the rate of persistent tympanic membrane perforation after intratympanic steroid injection. To determine which comorbid conditions and risk factors are associated with prolonged time to perforation closure following intratympanic steroid injection. MATERIALS AND METHODS: Clinical data were gathered for patients who had undergone intratympanic steroid injection to treat sudden sensorineural hearing loss or Ménière's disease. Primary outcomes analysis included rate of persistent tympanic membrane perforation, defined as perforation at least 90days following last injection, and time to perforation healing...
September 28, 2016: American Journal of Otolaryngology
Paul R Lambert, John Carey, Anthony A Mikulec, Carl LeBel
OBJECTIVE: To evaluate safety and efficacy of a single intratympanic injection of OTO-104, sustained-exposure dexamethasone, in patients with unilateral Ménière's disease. STUDY DESIGN: Randomized, double-blind, placebo-controlled, Phase 2b study over 5 months. SETTING: Fifty-two academic and community otolaryngology centers. PATIENTS: One hundred fifty four patients (77 per group) aged 18 to 85 years inclusive. INTERVENTION: Single intratympanic injection of OTO-104 (12 mg dexamethasone) or placebo...
September 30, 2016: Otology & Neurotology
A N Salt, J J Hartsock, R M Gill, E King, F B Kraus, S K Plontke
Intratympanic gentamicin therapy is widely used clinically to suppress the vestibular symptoms of Meniere's disease. Dosing in humans was empirically established and we still know remarkably little about where gentamicin enters the inner ear, where it reaches in the inner ear and what time course it follows after local applications. In this study, gentamicin was applied to the round window niche as a 20 μL bolus of 40 mg/ml solution. Ten 2 μL samples of perilymph were collected sequentially from the lateral semi-circular canal (LSCC) at times from 1 to 4 h after application...
October 8, 2016: Hearing Research
Yangming Leng, Bo Liu, Renhong Zhou, Jingjing Liu, Dongdong Liu, Su-Lin Zhang, Wei-Jia Kong
CONCLUSION: Intra-tympanic dexamethasone injection (ITD) could serve as a first-line intra-tympanic (IT) treatment for Meniere's disease (MD), regardless of hearing level. Even if the response to initial ITD course was unsatisfactory, a repeated course may be beneficial with some patients. OBJECTIVES: This study examined the effect of repeated courses of ITD administered on demand and investigated the possibility of ITD as an initial IT treatment for medically intractable MD patients...
September 21, 2016: Acta Oto-laryngologica
Fuat Ziylan, Diederik P J Smeeing, Inge Stegeman, Hans G X M Thomeer
No abstract text is available yet for this article.
September 16, 2016: Otology & Neurotology
J M Espinosa-Sanchez, J A Lopez-Escamez
Menière's disease (MD) is a chronic multifactorial disorder of the inner ear characterized by episodic vestibular symptoms associated with sensorineural hearing loss, tinnitus, and aural pressure. Epidemiologic and genomic evidence supports a genetic susceptibility with multiple biochemical pathways involved, including the endocrine system, innate immune response, and autonomic nervous system. Allergens, infectious agents, vascular events, or genetic factors could modify inner-ear homeostasis and trigger MD...
2016: Handbook of Clinical Neurology
Petros V Vlastarakos, Emily Iacovou, Thomas P Nikolopoulos
The aim of this study is to review the literature on sustained-release vehicles delivering gentamycin in the inner ear of patients suffering from Meniere's disease (MD), and critically assess their respective clinical effectiveness and safety. A systematic literature review was conducted in Medline and other database sources until January 2016, along with critical analysis of pooled data. Overall, six prospective and four retrospective studies were systematically analyzed. The total number of treated patients was 320...
September 13, 2016: European Archives of Oto-rhino-laryngology
Selin Ünsaler, Bora Başaran, Şule Öztürk Sarı, Eyüp Kara, Kemal Değer, Peter John Wormald
OBJECTIVES: To investigate the efficacy of chitosan-dextran hydrogel (CDH) in preventing postoperative adhesions between the tympanic membrane (TM) and intratympanic structures, and to evaluate its ototoxicity in an animal study. METHODS: In the first step, ototoxicity was evaluated with 7 male albino guinea pigs (GPs) via auditory brainstem responses (ABR) before and 4 weeks after unilateral intratympanic injection of CDH and saline solution contralaterally. In the second step, 12 GPs underwent bilateral ear surgery...
September 2, 2016: Audiology & Neuro-otology
Phillip Aitken, Alice Benoit, Yiwen Zheng, Bruno Philoxene, Anne Le Gall, Pierre Denise, Stephane Besnard, Paul F Smith
Permanent vestibular loss has detrimental effects on the hippocampus, resulting in a disruption to spatial learning and memory, hippocampal theta rhythm and place cell field spatial coherence. Little is known about the vestibular system-related hippocampal cholinergic transmission. Since the pharmacological blockade of muscarinic acetylcholine (ACh) receptors within the hippocampus produces deficits in learning and memory, we hypothesized that ACh receptors may at least partly support the integration of vestibular input...
August 29, 2016: Hippocampus
Koichiro Wasano, Shuta Tomisato, Sayuri Yamamoto, Noriomi Suzuki, Taiji Kawasaki, Kaoru Ogawa
OBJECTIVE: To report the treatment efficacy of continual intratympanic steroid injection (ITSI) therapy in a patient with refractory sensorineural hearing loss accompanied by relapsing polychondritis. PATIENT: A 49-year-old female diagnosed with relapsing polychondritis at the age of 45 years and who had been treated with corticosteroids and immunosuppressants developed sensorineural hearing loss in the left ear. INTERVENTION: Her unilateral hearing loss did not recover despite receiving one cyclophosphamide pulse treatment, one methylprednisolone pulse treatment, and weekly leukapheresis...
August 20, 2016: Auris, Nasus, Larynx
Clemens Honeder, Chengjing Zhu, Hanna Schöpper, Julia Clara Gausterer, Manuel Walter, Lukas David Landegger, Nodir Saidov, Dominik Riss, Roberto Plasenzotti, Franz Gabor, Christoph Arnoldner
It has been shown that glucocorticoids reduce the hearing threshold shifts associated with cochlear implantation. Previous studies evaluated the administration of glucocorticoids immediately before surgery or the repeated pre- or perioperative systemic application of glucocorticoids. The aim of this study was to evaluate the effects of a sustained release dexamethasone hydrogel in hearing preservation cochlear implantation. To address this issue, a guinea pig model of cochlear implantation was used. 30 normal hearing pigmented guinea pigs were randomized into a group receiving a single dose of a dexamethasone/poloxamer407 hydrogel one day prior to surgery, a second group receiving the hydrogel seven days prior to surgery and a control group...
August 9, 2016: Hearing Research
Kavita Dedhia, David H Chi
OBJECTIVES: 1. To report our experience in children with sudden-onset sensorineural hearing loss (SSNHL). 2. To describe the etiology and management of children with SSNHL. METHODS: Retrospective review of 20 children with SSNHL, from 2000 to 2013 at a tertiary pediatric facility. Patients had the following inclusion criteria: history of normal hearing, hearing loss occurring in less than 3 days, and audiogram documentation. RESULTS: The average age of patients presenting with SSNHL is 11 years 3 months (22months-18years)...
September 2016: International Journal of Pediatric Otorhinolaryngology
Ibrahima Youm, Umberto M Musazzi, Michael Anne Gratton, James B Murowchick, Bi-Botti C Youan
It is hypothesized that ferrocene (FC)-loaded nanocarriers (FC-NCs) are safe label-free contrast agents for cochlear biodistribution study by transmission electron microscopy (TEM). To test this hypothesis, after engineering, the poly(epsilon-caprolactone)/polyglycolide NCs are tested for stability with various types and ratios of sugar cryoprotectants during freeze-drying. Their physicochemical properties are characterized by UV-visible spectroscopy, dynamic light scattering, Fourier transform infrared spectroscopy, and scanning electron microscopy coupled with energy dispersive X-ray spectroscopy (SEM/EDS)...
October 2016: Journal of Pharmaceutical Sciences
Moslem Shaabani, Yones Lotfi, Seyed Morteza Karimian, Mehdi Rahgozar, Mehdi Hooshmandi
Current experimental research on the therapeutic effects of galvanic vestibular stimulation (GVS) has mainly focused on neurodegenerative disorders. However, it primarily stimulates the vestibular nuclei and could be potentially effective in modulating imbalance between them in the case of unilateral labyrinthectomy (UL). Fifty male Wistar rats (180-220g) were used in 5 groups of 10: intact, sham, right-UL (RUL; without intervention), and two other right-UL groups with GVS intervention [one group treated with low rate GVS (GVS...
October 1, 2016: Brain Research
Fredrik Tjernström, Per-Anders Fransson, Babar Kahlon, Mikael Karlberg, Sven Lindberg, Peter Siesjö, Måns Magnusson
OBJECTIVE: To evaluate auditory and vestibular function after presurgical treatment with gentamicin in schwannoma patients. BACKGROUND: The vestibular PREHAB protocol aims at diminishing the remaining vestibular function before vestibular schwannoma surgery, to ensure less acute symptoms from surgery, and initiate a more efficient vestibular rehabilitation already before surgery. However, the potential cochleotoxicity of gentamicin is a concern, since modern schwannoma surgery strives to preserve hearing...
July 19, 2016: Ear and Hearing
Hazem Saeed Amer, Mohammad Waheed El-Anwar, Alaa Eldin Elfeky
INTRODUCTION: Otitis media with effusion (OME) is a leading cause of hearing impairment in children. Therefore, early and proper management is essential. OBJECTIVES: The objective of this research is to assess the efficacy of intratympanic (IT) steroids injection for management of otitis media with effusion (OME). METHODS: This study involved 42 children (84 ears) with bilateral OME. We used tympanometry to confirm the childreńs middle ear effusion and pure tone audiometry to determine hearing threshold...
July 2016: International Archives of Otorhinolaryngology
Nezamoddin Berjis, Saeed Soheilipour, Alireza Musavi, Seyed Mostafa Hashemi
BACKGROUND: During the past years various drugs have been used for sudden sensorineural hearing loss (SSNHL) treatment including steroids that are shown to be beneficial. Directed delivery of high doses of steroids into the inner ear is suggested for its potential and known as intratympanic steroids therapy (IST). Despite the use of dexamethasone and methylprednisolone as the traditional treatments, there are still debates about the optimal dosage, preferred drug, and the route of administration...
2016: Advanced Biomedical Research
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