Hydrocortisone Suspension Research Articles

Effectiveness of hydrocortisone-procain blockages in patients with severe forms of trigeminal neuralgia

Purpose of work: to study the effectiveness of hydrocortisone-procaine blockades (HPB) in patients with severe forms of trigeminal neuralgia in the near and distant terms. The treatment of 46 patients with trigeminal neuralgia (TN) was analysed. Of them 16 were men (34.78 %), 30 women (65.22 %). They ranged in age from 20 to 88 (mean 62.20 ± 13.03) years. A mixture of 4.0 ml of 2 % procaine solution and 50 mg of hydrocortisone suspension (hydrocortisone-procaine mixture) was used to perform GPB, which was injected peri- and paraneurally into the “affected” branches of the trigeminal nerve according to the generally accepted technique. The total number of blockades varied from 1 to 5, with an average of 2.17 ± 1.27. The efficacy was evaluated at different times after the blockades using visual analogue scale and rating analogue scale at different times: before treatment, after 30 min, after 6 hours, 24 hours, after 3 days, 1 month, 3 months, 6 months, 1 year, 2 years and 3 years after the blockades. GPB of the peripheral branches of trigeminal nerve in 46 patients with severe pharmacoresistant forms of TN are effective in 100.00 % of patients in the first 3—6 hours after their performance. Further the analgesic effect of GPB decreases, especially in the nearest month, in connection with which there is a necessity to apply more radical techniques of neurosurgical treatment. Excellent long-term results (in 2—3 years) after blockades application on the background of adequately selected pathogenetic therapy of both the main and accompanying diseases of the nervous system and internal organs were achieved in 8 (17.39 %) out of 46 patients. The analysed data indicated that GPB of peripheral branches of trigeminal nerve can be used in the treatment of pain syndrome in TN. Key words: trigeminal neuralgia, drug denervation, hydrocortisoneprocaine blockades

Practice Variation among Pediatric Endocrinologists in the Dosing of Glucocorticoids in Young Children with Congenital Adrenal Hyperplasia.

A Pediatric Endocrine Society (PES) Drugs and Therapeutics Committee workgroup sought to determine the prescribing practices of pediatric endocrinologists when treating children <10 years of age with congenital adrenal hyperplasia (CAH). Our workgroup administered a 32-question online survey to PES members. There were 187 respondents (88.9% attending physicians), mostly from university-affiliated clinics (~80%). Ninety-eight percent of respondents prescribed the short-acting glucocorticoid hydrocortisone to treat young children, as per the Endocrine Society CAH Guidelines, although respondents also prescribed long-acting glucocorticoids such as prednisolone suspension (12%), prednisone tablets (9%), and prednisone suspension (6%). Ninety-seven percent of respondents indicated that they were likely/very likely to prescribe hydrocortisone in a thrice-daily regimen, as per CAH Guidelines, although 19% were also likely to follow a twice-daily regimen. To achieve smaller doses, using a pill-cutter was the most frequent method recommended by providers to manipulate tablets (87.2%), followed by dissolving tablets in water (25.7%) to create a daily batch (43.7%) and/or dissolving a tablet for each dose (64.6%). Thirty-one percent of providers use pharmacy-compounded hydrocortisone suspension to achieve doses of <2.5 mg. Our survey shows that practices among providers in the dosing of young children with CAH vary greatly and sometimes fall outside of the CAH Guidelines-specifically when attempting to deliver lower, age-appropriate hydrocortisone doses.

Bone Age Maturation and Growth Outcomes in Young Children with CAH Treated with Hydrocortisone Suspension.

BackgroundYoung children with congenital adrenal hyperplasia (CAH) require small doses (0.1-1.25 mg) of hydrocortisone (HC) to control excess androgen production and avoid the negative effects of overtreatment. The smallest commercially available HC formulation, before the recent US Food and Drug Administration approval of HC granules, was a scored 5-mg tablet. The options to achieve small doses were limited to using a pharmacy-compounded suspension, which the CAH Clinical Practice Guidelines recommended against, or splitting tablets into quarters or eighths, or dissolving tablets into water.MethodsCross-sectional chart review of 130 children with classic CAH treated with tablets vs a pharmacy-compounded alcohol-free hydrocortisone suspension to compare growth, weight, skeletal maturation, total daily HC dose, and exposure over the first 4 years of life.ResultsNo significant differences were found in height, weight, or body mass index z-scores at 4 years, and in predicted adult height, before or after adjusting for age at diagnosis and sex. Bone age z-scores averaged 2.8 SDs lower for patients on HC suspension compared with HC tablets (P < 0.001) after adjusting for age at diagnosis and sex. The suspension group received 30.4% lower (P > 0.001) average cumulative HC doses by their fourth birthday.ConclusionsOur data indicate that treatment with alcohol-free HC suspension decreased androgen exposure as shown by lower bone age z-scores, allowed lower average and cumulative daily HC dose compared to HC tablets, and generated no significant differences in SDS in growth parameters in children with CAH at 4 years of age. Longitudinal studies of treating with smaller HC doses during childhood are needed.

Hydrocortisone Suspension Provides Similar Growth Outcomes as Hydrocortisone Tablets in Young Children With Congenital Adrenal Hyperplasia: A Cross Sectional Study

Abstract Young children with CAH require small doses (0.1–1.25mg) and incremental adjustments of hydrocortisone (HC) to control excess androgen production and avoid the negative effects of overtreatment. A recent 6 hour pharmacokinetic/pharmacodynamic study reported that alcohol-free HC suspension provides similar cortisol exposure to tablets (1), but more data is needed to assess its clinical efficacy. We performed a chart review to determine the effect of the alcohol-free HC suspension compared to tablets on height, weight, BMI, bone age z-scores and corrected height z-scores to target height z-scores in children aged 2 yrs and 4 yrs in a cohort with classic CAH. Independent 2-sample t-tests examined cumulative and average HC dose at 2 and 4 yrs. Triple logistic modeling of longitudinal heights were used to calculate predicted near-adult height. Adjusted linear regression models assessed the effect of HC suspension compared to tablets on final adult height. Charts of 130 children (70 females, 100 salt wasting and 30 simple virilizing) were reviewed. At 2 yrs, 97 were treated with tablets and 33 with suspension (17 previously switched from tablets). At 4 yrs, 89 were treated with tablets and 41 with suspension (25 switched). No significant differences in height or BMI z-scores at both 2 and 4 yrs, before or after adjusting for age at diagnosis and sex were found. Bone age z-scores averaged 7.2 SDs lower for patients treated with HC suspension only compared to patients on HC tablets at age 4 (p&amp;lt;0.001), and 5.93 SDs lower for patients switched from tablets to suspension compared to tablets (p&amp;lt;0.001). The suspension group received 16% lower (p=0.055) and 25% lower (p=0.002) cumulative HC doses by the ages of 2 yrs and 4 yrs respectively. Average daily HC dose was lower by 3.44 and by 4.46 mg/m2/d over the first 2 and 4 yrs of life respectively. No significant differences were found between patients treated with tablets and suspension in the predicted final adult height, its z-score or its corrected z-score to target height after adjusting for age at diagnosis, sex and diagnosis. Our data indicates that treatment with alcohol-free HC suspension decreased androgen exposure as shown by lower bone age z-scores, generated no significant differences in SDS in observed height, BMI or predicted near-adult height, and allowed for lower average and cumulative daily HC dose compared to HC tablets in children with CAH. Reference: (1) Sarafoglou et al., J Clin Pharmacol.2015;55(4):452–7.

Response to 'Hydrocortisone suspension formulations are not necessarily the same in the treatment of children with congenital adrenal hyperplasia'.

Response to 'Hydrocortisone suspension formulations are not necessarily the same in the treatment of children with congenital adrenal hyperplasia'.

Enhanced Skin Permeation of Hydrocortisone Using Nanoemulsion as Potential Vehicle

AbstractThe current work was performed to estimate the solubility and Hansen solubility parameters of a poorly soluble corticosteroid hydrocortisone (HCN) in various components of nanoemulsion and to enhance the skin permeation rate of HCN using nanoemulsions as potential vehicles. Screening studies suggested the use of Capryol‐90 (oil), Triton‐X100 (surfactant) and Transcutol‐HP (cosurfactant) in the preparation of HCN nanoemulsions. HCN nanoemulsions were developed using low energy emulsification technique and characterized for droplet size, plolydispersity index (PDI), zeta potential (ZP), refractive index (RI), percent of transmittance (% T) and transmission electron microscopy (TEM) and evaluated for drug release behavior. Selected nanoemulsions and control (HCN suspension) were subjected to in vitro skin permeation studies. Optimized formula HSN8 showed droplet size of 52.6 nm, PDI of 0.109, ZP of −33.72 mV, RI of 1.337 and % T of 97.68%. TEM confirmed spherical‐shaped droplets in nanometer range. In vitro drug release evaluation suggested significant release of HCN from optimized nanoemulsion (98.52%) compared with control (35.85%). Skin permeation profile of HCN from optimized nanoemulsion was also significant compared with control. These results suggested the potential of nanoemulsion in enhancing the transdermal delivery of HCN via rat skin.

Определение изменений устойчивости молекулярного химического состава лекарственных препаратов, используемых при низкочастотной ультразвуковой терапии в оториноларингологии

The article discusses the possibility and the results of applying the nuclear magnetic resonance spectroscopy (NMR spectroscopy) as an objective assessment of chemical stability of the molecular compositions of medical preparations used for phonophoretic injection into biological tissues by exposing them to low-frequency ultrasound. It is based on the interaction of an external magnetic field with the nuclei of the molecules of a substance, which, when exposed to a radio pulse of a certain frequency, change their energy levels, emitting electromagnetic radiation. This effect provides the image of the oscillations from all the resonating nuclei of chemical composition, state, and structure different from those of the analyte. The studied preparations are hydrocortisone suspension; dexamethasone solution; 2% lidocaine solution; lydasum aqueous solution; lydasum, dissolved in 2% lidocaine, before and after their single sonic treatment at the resonant frequency of 25–26 kHz for 120 seconds. The results of the study were evaluated by the spectral characteristics of samples of medicinal substances. It has been proven that these preparations after ultrasonic “agitation” preserve the identity of their molecular chemical composition and, within the designated period, can be used for phonophoretic injection into biological tissues. In general, the method of NMR spectroscopy should be recommended to check the integrity of any medicinal substances before their injection into human body using physical technologies. Keywords: medicinal solutions, low-frequency ultrasound, molecular chemical composition, nuclear magnetic resonance spectroscopy.

Potentiation of Otoprotective Effect of Hydrocortisone Immobilized on Povidone Nanoparticles under Conditions of Intravenous Injection.

The otoprotective effect of immobilized hydrocortisone was studied on the model of acute acoustic injury to the auditory analyzer in male Wistar rats. The effects of true solution and suspension where polyvinylpyrrolidone particles (100-500 nm) served as dispersed phase (hydrocortisone concentration 5 mg/kg). The agents were administered immediately after continuous acoustic stimulation: 5 kHz tone, 110 dB for 2 h. The hearing status was evaluated by the amplitude of otoacoustic emission at the distortion product frequency (4-6.4 kHz) 1 and 24 h and 7 days after acoustic stimulation. Single injection of hydrocortisone suspension caused a more pronounced therapeutic effect within 1 day after acoustic stimulation.

Method of Treatment Posttraumatic Synovitis Using Aqueous Anolyte and Catholyte

Актуальность Ведение больных с посттраматическим синовитом в настоящее время стоит в ряду особенно актуальных. Около 15% острых постравматических синовитов переходят в хронические, гнойные артриты, постравматические контрактуры и деформирующие артрозы.Цель исследования Изучить эффективность применение электроактивированных водных растворов анолита и католита в комплексе лечения больных с посттравматическими синовитами.Материал и методы Статья основана на опыте лечения 88 пациентов с посттравматическим синовитом. Пациенты были распределены на 2 группы: 23 пациента 1-й группы получали лечение традиционным способом: внутрисуставно иньекционно вводился р-р диоксидина 1% в количестве 10 мл и суспензия гидрокортизона 2,5% 1 раз в 3 дня в течение 12 дней. 65 пациентам 2-й группы внутрисуставно иньекционно вводили стандартизованный анолит 0.3% раствора натрия хлорида (нейтральный рH 7,3-7,7 ОВП +700-1100 мВ) в количестве 10 мл через 3 дня в течение 9-10 дней, одновременно внутрь вводился ежедневно католит 0.3% раствора натрия хлорида (ОВП минус 450-600 мВ, рН – 7.7-7.9) 3 раза в сутки до еды по 100 мл в течение всего периода болезни до максимального уменьшения воспалительных явлений в суставах.Результаты и их обсуждение Применение внутрисуставного и параартикулярного метода введения анолита, совместно с парентеральным использованием католита, позволяет быстрее санировать полость сустава, уменьшить отек, воспаление и интоксикацию организма. Предлагаемый способ лечения посттравматических синовитов позволяет получить дополнительные эффекты лечения: улучшить метаболизм синовиальной жидкости и хряща, в более ранние сроки быстрее купировать болевой синдром.Выводы Проводимое лечение позволило сократить сроки лечения в стационаре в среднем на 4-5 койко/дня и отказаться от курса физиотерапии. Курс лечения продолжался не менее девяти дней.

Ototoxicity of Polymyxin B, Neomycin, and Hydrocortisone Suspension in Tympanoplasty Surgery

(1) To determine the safety of using a commercially available suspension of polymyxin B, neomycin, and hydrocortisone (PNH) in tympanoplasty surgery. (2) To apply evidence-based medicine to tympanoplasty surgery when considering potential ototoxicity. Case series with chart review. Tertiary otology practice, single surgeon. Approval for this study was obtained from the St. Dominic-Jackson Memorial Hospital Institutional Review Board. Data were gathered on 272 consecutive type 1, underlay tympanoplasties for which both pre- and postoperative audiometric data were available over a 10-year period. In each surgery, gelatin sponge saturated in a commercially available PNH suspension was placed in the middle ear to support the graft. Patients ranged in age from 3 years to 79 years. Preoperative and postoperative bone conduction thresholds were measured at 500, 1000, 2000, 3000, and 4000 Hz. The average change in sensorineural hearing as measured by bone conduction thresholds was negligible, with a slight improvement in all frequencies tested except 4000 Hz. The changes by frequencies were as follows: 500 Hz (-1.624 dB), 1000 Hz (-1.399 dB), 2000 Hz (-0.975 dB), 3000 Hz (-0.596 dB), and 4000 Hz (+0.560 dB). The 5-frequency average change was -0.545 dB. The commonly used otic solution containing polymyxin B, neomycin, and hydrocortisone demonstrates no ototoxicity in tympanoplasty surgery and is safe to use in this setting.

Ototoxicity of Polymyxin B, Neomycin, and Hydrocortisone Suspension in Tympanoplasty Surgery

Objectives: 1) Determine the safety of using a commercially available suspension of polymycin B, neomycin, and hydrocortisone in tympanoplasty surgery.2) Apply evidence based medicine in tympanoplasty surgery when considering potential ototoxicity. Methods: Study Design: Retrospective chart review. Setting: Tertiary otology practice, single surgeon. Data were gathered on 277 consecutive type 1, underlay tympanoplasties for which both pre- and postoperative audiometric data were available over a 10 year period. In each surgery, gelatin sponge saturated in a commercially available suspension of polymycin B, neomycin, and hydrocortisone was placed in the middle ear to support the graft. Patients ranged from age 3y/o to 79y/o. Preoperative and postoperative bone conduction audiometric thresholds were measured at 500, 1000, 2000, 3000, and 4000Hz. Results: The average change in sensorineural hearing as measured by bone conduction thresholds was negligible, with a slight improvement in all frequencies tested except 4000Hz. The changes by frequencies were as follows: 500Hz (-1.624dB), 1000Hz (-1.399dB), 2000Hz (-0.975), 3000Hz (-0.596dB), and 4000Hz (+0.56dB). The five frequency average change was (-0.545dB). Conclusions: The commonly used otic solution containing polymycin B, neomycin, and hydrocortisone demonstrates no ototoxicity in tympanoplasty surgery and is safe to use in this setting.

Hydrocortisone Suspension and Hydrocortisone Tablets Are Not Bioequivalent in the Treatment of Children with Congenital Adrenal Hyperplasia

Hydrocortisone Suspension and Hydrocortisone Tablets Are Not Bioequivalent in the Treatment of Children with Congenital Adrenal Hyperplasia

Hydrocortisone Suspension and Hydrocortisone Tablets Are Not Bioequivalent in the Treatment of Children with Congenital Adrenal Hyperplasia

In July 1998, Cortef oral suspension (Pharmacia & Upjohn) was reformulated changing the suspending agent tragacanth to xanthan gum. We subsequently observed suboptimal control of hormone levels in a group of children with classic congenital adrenal hyperplasia, despite increasing doses of Cortef suspension and stringent instructions to parents regarding shaking of the bottles of medication. Nineteen children receiving Cortef and fludrocortisone therapy were changed to hydrocortisone tablets and fludrocortisone, with a 10 percent reduction in hydrocortisone dose. A significant decrease in 17-hydroxyprogesterone (235 +/- 120 vs. 27 +/- 7 nmol/L; p</=0.001) and androstenedione (18.9 +/- 18.0 vs. 3.5 +/- 3.5 nmol/L; p=0.002) was observed 4-6 weeks later. Twenty-one percent (4/19) had 17-hydroxyprogesterone and androstenedione levels at or below the detection limit of the assay. Despite a significant reduction in glucocorticoid dose (19.6 +/- 4.7 vs. 17.6 +/- 3.9 mg/M(2)/day; p<0.001), eight children experienced significant weight gain and appetite increase, three experienced trouble sleeping, four experienced moodiness, and three developed hypertension requiring a decrease in fludrocortisone therapy. Hydrocortisone dose was further decreased to 15.2 +/- 2.6 mg/M(2)/day with resolution of symptoms. We conclude that Cortef suspension and hydrocortisone tablets are not bioequivalent and the reformulated form of hydrocortisone oral suspension was inadequate in the control of children with congenital adrenal hyperplasia. Cortef suspension has been recalled as a result of these data.

Controlled multicenter study on chronic suppurative otitis media treated with topical applications of ciprofloxacin 0.2% solution in single-dose containers or combination of polymyxin B, neomycin, and hydrocortisone suspension

Otic drops of either ciprofloxacin 0.2% solution (CIP) or a combination of polymyxin B, neomycin, and hydrocortisone suspension (PNH) were administered for 6 to 12 days to patients (14-71 years old) with chronic suppurative otitis media in a randomized, nonblinded, multicenter clinical trial. Two hundred thirty-two enrolled patients were analyzed for efficacy on a “per protocol” basis. The most frequently identified causal agents were Staphylococcus aureus (28% of the patients), Pseudomonas aeruginosa (19%), and Staphylococcus sp (9%). Clinical success was observed in 91% and 87% of the CIP-and PNH-treated patients, respectively. At 1-month follow-up, 4% of CIP and 6% of PNH patients showed a relapse of otorrhea. Bacteriologic eradication was seen in 89% and 85% of patients in the CIP and PNH groups, respectively. At 1-month follow-up, reinfection or recurrence of infection appeared in 3 patients in the PNH group and in 1 patient in the CIP group. Both treatments were well tolerated. The most frequently reported adverse events were pruritus, stinging, and earache. Audiometric tests did not show changes attributable to study drugs in any but 1 patient in the PNH group. This clinical trial shows that topical 0.2% ciprofloxacin solution in single-dose containers is effective and well tolerated in patients with chronic suppurative otitis media. (Otolaryngol Head Neck Surg 2000;123:617-23.)

Considerations in the use of hydroxypropyl-β-cyclodextrin in the formulation of aqueous ophthalmic solutions of hydrocortisone

The in vivo ocular bioavailability of hydrocortisone (HC) in the NZW rabbit was determined following topical administration of solutions containing HC (1%) with hydroxypropyl-β-cyclodextrin (HP-β-CD) alone, or containing the mucoadhesive, viscosity enhancing polymers sodium hyaluronate (0.2 and 0.5% w/v) or Carbopol 934P (0.1% w/v). A 1% HC suspension was used as control. Formulation of HC as a solution with HP-β-CD in the absence of polymer increased the bioavailability of HC in the aqueous humour by approximately 55% and cornea by 75% when compared to suspension. Inclusion of either polymer did not result in any further increase in ocular bioavailability over that noted for the polymer-free solution. The in vitro corneal permeability of HC was also evaluated. A linear relationship ( r 2=0.999) was noted between corneal permeability and the concentration of free (uncomplexed) HC in solution. Permeability was greatest when formulated either as a suspension, or as an HP-β-CD solution in which the concentration of free (uncomplexed) HC is equivalent to that of a saturated solution. Thus, when using cyclodextrins in the reformulation of ophthalmic suspensions as solutions, consideration must be given to the concentration of cyclodextrin used and to the benefits of including viscosity enhancing polymers.

Effect of hydrocortisone on amine content in the thymus

Intraperitoneal injection of 2.5% hydrocortisone suspension (0.5 ml) changes the content of biogenic amines in different lobule zones and thymocytes of high animals. The content of norepinephrine and serotonin increases in luminescent cells of the subcapsular and premedullary zones and decreases in mast cells.

Effect of novel penetration enhancers on the transdermal delivery of hydrocortisone: an in vitro species comparison

Six novel compounds were examined for enhancer activity using occluded hairless mouse skin (HM), hairless rat skin (HR), human cadaver skin (HC) in vitro with hydrocortisone as the model drug. The compounds investigated included: N-dodecyl-2-pyrrolidinone (DPY), N-dodecyl-2-piperidinone (DPI), N-dodecyl- N-(2-methoxyethyl)acetamide (DMEA), N-dodecyl- N-(2-methoxyethyl)isobutyramide (DMEI), N-dodecyldiethanolamine (DDE), 2-(1-nonyl)-1,3-dioxolane (ND), and Azone®. Controls consisted of no enhancer or vehicle treatment. All enhancers were applied at 0.4 M in propylene glycol 1 h prior to skin application of a saturated suspension of hydrocortisone in the same vehicle. Enhancement ratios (ER) were determined for 24 h diffusion cell receptor concentrations (Q 24), permeability coefficients (P), and 24 h full-thickness skin steroid contents. ER for controls was 1.0. N-dodecyl-2-pyrrolidinone (DPY), an Azone® analog, showed the greatest ER values for permeability coefficient (HM: 21.3, HR: 20.7, HC: 8.0) compared to control (ER: 1.0) and Azone® (HM: 18.0, HR: 13.1, HC: 5.5) in all three animal skin models. All six enhancers exhibited poor skin steroid retention (compared to Azone®) in all three skin models.

Investigation of enhancer structure activity relationships in congeners of 2-(1-nonyl)-1,3-dioxolane

AbstractTwelve analogues of 2-(1-nonyl)-1,3-dioxolane were examined for enhancer activity using occluded hairless mouse skin in vitro with hydrocortisone as the model drug. Controls consisted of no enhancer or vehicle pretreatment (I) or propylene glycol pretreatment 1 h prior to drug application (II). Enhancers were applied at 0.4 M in propylene glycol (PG) 1 h prior to skin application of a saturated suspension of hydrocortisone in the same vehicle. The highest 24-h receptor concentration (Q24) of steroid was observed using 2-(1-nonyl)-1,3-dioxolane: 131.472 ± 20.659 μM compared to Control I of 16.462 ± 4.859 Rm. Control II Q24 values were 34.015 ± 9.959 μm. The highest skin steroid content was produced by 2-(1-nonyl)-2-methyl-1,3-dioxolane: 431.4 ± 212.2 μg g-1 and 2-(1-nonyl)-2,4-dimethyl-1,3-dioxolane: 385.7 ± 138.7 μg g-1. Skin steroid content of Control I was 490.2 ± 243.2 μg g-1 and of II was 112.7 ± 31.3 μg g-1. Control I and II results indicated that PG was exhibiting enhancer activity. All 12 d...

Animal Model for Persistent Tympanic Membrane Perforations

Topically applied hydrocortisone was used to develop an animal model for persistent tympanic membrane (TM) perforations. Hydrocortisone suspension was applied on the margins of TM perforations of standardized size in rats once daily for 10 days. The healing patterns of the TMs were mapped weekly and, when the perforations were about to close, daily. After 50 days, all hydrocortisone-treated perforations were open, whereas the controls closed within 9 to 12 days. At 3 months, when one third of the perforations still were open, the TMs were studied by otomicroscopy and light microscopy. All TMs were thickened and covered by keratin and wax. The thickened epidermal layer at the border of the TM perforations that remained open also draped the surface of the perforation facing the middle ear cavity. The thickened connective tissue layer contained abundant fibroblasts with their axes of length oriented at random. Both application of 1.4% hyaluronan and wounding of the perforation border enhanced the healing rate of the hydrocortisone-induced chronic TM perforation.

Structural changes in the round window membrane following exposure to escherichia coli lipopolysaccharide and hydrocortisone

The present study focused on structural changes of the round window membrane (RWM) from agents that evoke transient or permanent impairment of the auditory brainstem response when applied into the RW niche. Escherichia coli (E. coli) lipopolysaccharide (LPS) in sterile water (SW) and a 2% suspension of hydrocortisone (CORT), micronized in SW, were instilled into the round window (RW) niche of Sprague-Dawley rats. The morphology of the RWM was analyzed 3 to 21 days after instillation of either substance. Both substances caused minor structural alterations at the light microscopic level. The RWM showed a slight thickening and an invasion of inflammatory cells. At the ultrastructural level, the CORT-treated specimens showed an increased epithelial height and numerous microvilli, whereas the epithelium of the LPS-treated specimens was extended and contained few microvilli resembling those in the normal RWM. We postulate that the RWM may undergo dynamic structural changes when exposed to various agents. The structural alterations per se can influence the passage of substances from the middle ear to the inner ear.