Abstract
IntroductionMiddle ear application of gentamicin is a common medical treatment for uncontrolled Ménière’s disease. The objective of the study was to evaluate the impact of endolymphatic hydrops on inner ear delivery.MethodsPerilymph gentamicin concentrations and correlation with endolymphatic hydrops in an animal model were assessed. A group of 24 guinea pigs was submitted to surgical obstruction of the endolymphatic sac and duct of the right ear. Gentamicin was applied either to the right ear’s round window niche or through a transtympanic injection. Perilymph specimens were collected at different times. Histologic morphometry was used to evaluate both turn-specific and overall hydrops degree.ResultsIn animals with endolymphatic hydrops, lower concentrations of gentamicin were observed after 20 or 120 minutes of exposure and in both types of administration, when compared to controls. This difference reached statistical significance in the round window niche application group (Mann-Whitney, p = 0,007). A negative correlation between perilymphatic gentamicin concentration and hydrops degree could be observed in both groups, after 120 minutes of exposure (Spearman correlation, round window niche p<0,001; TT p = 0,005).ConclusionsThe study indicates that the endolymphatic hydrops degree has a negative interference on the delivery of gentamicin into the inner ear following middle ear application.
Highlights
Middle ear application of gentamicin is a common medical treatment for uncontrolled Menière’s disease
The study indicates that the endolymphatic hydrops degree has a negative interference on the delivery of gentamicin into the inner ear following middle ear application
Menière’s disease (MD) is described by episodic vertigo associated with low/medium-frequency sensorioneural hearing loss and fluctuating symptoms in the affected ear [1]. This disorder has been associated with an increased volume of endolymph in the membranous labyrinth–endolymphatic hydrops (EH)
Summary
The objective of the study was to evaluate the impact of endolymphatic hydrops on inner ear delivery. The aim of the present study was to understand how the EH degree influences the course of drugs, such as gentamicin, to the inner ear, after middle ear delivery
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