Ototoxicity of Povidone-Iodine applied to the middle ear cavity of guinea pigs

Abstract

Objective Povidone-Iodine preparation is used as a disinfectant in otological surgeries. The ototoxicity of Povidone-Iodine preparation was evaluated using infant, young and adult guinea pigs. The effects of different concentrations and of different exposure durations on compound action potentials were also studied. Materials & methods Povidone-Iodine was used to fill one middle ear cavity of the guinea pig, and the compound action potential (CAP) was measured from the round window membrane at 24 h, 7 days, and 28 days. The contralateral side was filled with saline as control. Test sounds used were clicks and tone bursts of 2, 4, and 8 kHz. Results At 24 h, Povidone-Iodine solution showed a significant toxic effect in the infant group. In the young animal group, no toxic effect was seen. In the adult group, a mild degree of deafness for 2 kHz was found. At 7 days, the young group showed significant hearing loss for all frequencies, but the adult group did not show any hearing loss. With a half strength solution, both young and adult group did not show hearing loss. At 28 days, with a full strength solution, hearing loss became prominent for all sound stimulation. With 1/8th dilution, the young group showed a moderate hearing loss, but the adult group did not. Conclusion The thicker round window membrane in human is expected to provide more protection to the human cochlea than in the guinea pig model that we have studied. Mild hearing loss at 24 h and 7 days using 10% solution, but no hearing loss with 5% solution at 7 days may indicate that rinsing of the middle ear cavity with saline during surgery should minimize the ototoxic effect of this product. The age of the animals does influence the outcome of the ototoxicity experiment. From this experiment, Povidone-Iodine preparations in the infant should be used with caution. Povidone scrub should not be used for otologic surgery.