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Marques P, Duan M, Perez-Fernandez N, Spratley J. Gentamicin delivery to the inner ear: Does endolymphatic hydrops matter? PLoS One 2018; 13:e0207467. [PMID: 30440019 PMCID: PMC6237362 DOI: 10.1371/journal.pone.0207467] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Accepted: 10/31/2018] [Indexed: 12/13/2022] Open
Abstract
Introduction Middle 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. Methods Perilymph 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. Results In 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). Conclusions 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.
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Affiliation(s)
- Pedro Marques
- Department of Otorhinolaryngology, S.João Hospital Centre, Porto, Portugal
- Unit of Otorhinolaryngology, Department of Surgery and Physiology, University of Porto Medical School, Porto, Portugal
- * E-mail:
| | - Maoli Duan
- Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
- Department of Otolaryngology, Head and Neck Surgery, Karolinska Universisty Hospital, Karolinska Institutet, Stockholm, Sweden
| | | | - Jorge Spratley
- Department of Otorhinolaryngology, S.João Hospital Centre, Porto, Portugal
- Unit of Otorhinolaryngology, Department of Surgery and Physiology, University of Porto Medical School, Porto, Portugal
- Center for Health Technology and Services Research (CINTESIS), University of Porto Medical School, Porto, Portugal
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Dai C, Gan RZ. Change in cochlear response in an animal model of otitis media with effusion. Audiol Neurootol 2009; 15:155-67. [PMID: 19776565 PMCID: PMC2853584 DOI: 10.1159/000241096] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2008] [Accepted: 06/12/2009] [Indexed: 11/19/2022] Open
Abstract
Our previous studies confirm that middle ear mobility is reduced in the presence of otitis media with effusion (OME). Variations in middle ear function may result in changes in cochlear response in OME ears. With the long-term goal of evaluating cochlear function in OME ears, the aim of this study was to measure the displacement of the basilar membrane (BM) in guinea pig ears with OME. Vibrations of the BM at the apex and basal turn were measured in an in vitro preparation extracted 3 and 14 days after injection of lipopolysaccharide in the middle ear of guinea pigs. The results show that the displacement sensitivity of the BM at the apex and the basal turn to sound pressure in the ear canal was reduced up to 25 dB at their characteristic frequencies, respectively. Cochlear gain with respect to umbo movement was also changed in ears with OME in both groups. This study provides data for analysis of the change of BM vibration in a guinea pig OME model.
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Nakashima T, Naganawa S, Sugiura M, Teranishi M, Sone M, Hayashi H, Nakata S, Katayama N, Ishida IM. Visualization of endolymphatic hydrops in patients with Meniere's disease. Laryngoscope 2007; 117:415-20. [PMID: 17279053 DOI: 10.1097/mlg.0b013e31802c300c] [Citation(s) in RCA: 416] [Impact Index Per Article: 24.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Recently, there have been many reports of intratympanic gentamicin therapy for the treatment of intractable Meniere's disease. Intratympanic administration of steroids has also been used to treat sudden sensorineural hearing loss. We attempted to visualize how the intratympanically administered drug enters the inner ear. METHODS Gadolinium hydrate diluted eightfold with saline was injected intratympanically through the tympanic membrane using a 23 G needle in nine patients with inner ear diseases. With a 3 Tesla magnetic resonance imaging (MRI) unit, three-dimensional fluid-attenuated inversion recovery (3D-FLAIR) imaging was performed. RESULTS 3D-FLAIR MRI clearly revealed that the gadolinium entered the perilymphatic space and delineated the perilymphatic and endolymphatic spaces of the inner ear. In patients with endolymphatic hydrops, the perilymphatic space surrounding the endolymph was small or had disappeared. Gadolinium appeared first in the scala tympani of the basal turn of the cochlea and the perilymphatic space of the vestibule. One day after the intratympanic injection of gadolinium, the gadolinium was observed in almost all parts of the perilymph. Six days after the intratympanic injection, the gadolinium had almost disappeared from the inner ear. CONCLUSION We reported the first visualization of endolymphatic hydrops in patients with Meniere's disease. The relationship between the image of the endolymphatic space and functional tests, such as electrocochleography and vestibular-evoked myogenic potential, must be examined in the near future. It is important for the development of intratympanic drug therapies for inner-ear diseases to investigate how the drugs enter and leave the inner ear.
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Affiliation(s)
- Tsutomu Nakashima
- Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
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Qiu J, Olivius P, Tong B, Borg E, Duan M. Ventral approach to rat inner ear preserves cochlear function. Acta Otolaryngol 2007; 127:240-3. [PMID: 17364359 DOI: 10.1080/00016480600818104] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
CONCLUSION This technique enabled us to visualize the cochlea without causing damage. OBJECTIVE The mammalian inner ear is difficult to approach surgically. This is particularly true in the cases of the rat and mouse, which both have small cochleae. Rat and mouse research is particularly important because their genomes are well characterized, and significantly similar to that of the human. The aim of the present study was to develop a method of accessing the rat cochlea without affecting its function. MATERIALS AND METHODS In the ventral approach, a small hole was made for access to the scala tympani. Cochlear function was assessed through auditory brainstem response (ABR) threshold measurements. RESULTS The ventral approach enabled the direct visualization of the tympanic bulla. Thus, the tympanic bulla could be easily opened in a manner that was benign to cochlear function. There was no significant difference in ABR threshold before and after surgery.
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Affiliation(s)
- Jianxin Qiu
- Department of Otolaryngology, Affiliated Hospital of Anhui Medical University, Hefei, China
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Bodet E, Martínez V, Romeu C. [Cochlear involvement in acute otitis media]. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2005; 56:396-9. [PMID: 16353784 DOI: 10.1016/s0001-6519(05)78636-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE An experimental design with mice has been realized to understand the origin of sensorial hearing loss related to infectious processes in the middle ear. Our aim is to study if the cilliated cells in the Corti organ's are lost after one or more acute otitis media. MATERIAL AND METHODS For that, thirty Sprague-Dawley mice have been divided in two groups. In the first one, we have induced one acute otitis media, in the second group we have induced two infections of this kind. RESULTS The statistic study shows that the loss of the cilliated cells is greater in the basal turn of the mice is cochlea, in the first group (alpha=0,020) and also in the second (alpha=0,038). We've noticed in the first group the near absence of injury in the middle turn, but in all samples of the second group we found that injury (alpha=0,002). CONCLUSIONS In acute otitis media, the loss of ciIliated cells are mainly in the basal turn of the mice is cochlea, and affects the middle turn when the infection is repeated.
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Affiliation(s)
- E Bodet
- Unidad de Otorrinolaringología Hospital Nostra Senyora de Meritxell Avinguda Fiter i Rossell, 1-13 Escaldes-Engordany.
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Pinilla M, Ramírez-Camacho R, Jorge E, Trinidad A, Vergara J. Ventral approach to the rat middle ear for otologic research. Otolaryngol Head Neck Surg 2001; 124:515-7. [PMID: 11337654 DOI: 10.1067/mhn.2001.115370] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVE To describe a simple approach to the rat middle ear because there are few clear descriptions of this technique with minimal morbidity and mortality. STUDY DESIGN AND SETTING Six male Long-Evans rats were used in this study. We designed a cervical approach to the middle ear with the purpose of creating an experimental model of ossiculoplasty that permits the postoperative survival of the animal. RESULTS It was possible in all cases to visualize the majority of structures of the tympanic cavity: promontory, round window, stapedial artery, stapes, incus, and tympanic membrane. There were no cases of postoperative infection or facial paralysis. CONCLUSIONS AND SIGNIFICANCE The ventral approach to the rat middle ear is a rapid and simple technique that makes the rat the animal of choice for many otologic investigations.
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Affiliation(s)
- M Pinilla
- Department of Otorhinolaryngology, Clínica Puerta de Hierro, Universidad Autónoma, Madrid, Spain.
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Abstract
Therapeutic manipulations of the mammalian cochlea, including cochlear gene transfer, have been predominantly studied using the guinea pig as the experimental model. With the significant developments in mouse genomics and the availability of mutant strains of mice with well-characterized hearing loss, the mouse justifiably will be the preferred animal model for therapeutic manipulations. However, the potential advantages of the mouse model have not been fully realized due to the surgical difficulty of accessing its small cochlea. This study describes a ventral approach, instead of the routinely used postauricular approach in other rodents, for accessing the mouse middle and inner ear, and its application in cochlear gene transfer. This ventral approach enabled rapid and direct delivery of liposome-transgene complex to the mouse inner ear while avoiding blood loss, facial nerve morbidity, and mortality. Transgene expression at 3 days was detected in Reissner's membrane, spiral limbus, spiral ligament, and spiral ganglion cells, in a pattern similar to that previously described in the guinea pig. The successful access and delivery of material to the mouse cochlea and the replication of gene expression seen in the guinea pig demonstrated in this study should promote the use of the mouse in future studies investigating targeted cochlear therapy.
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Affiliation(s)
- J Jero
- Laboratory of Molecular Oncology, Epstein Laboratories, Department of Otolaryngology, Head and Neck Surgery, University of California, San Francisco, 94143-0526, USA
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van Cauwenberge P, Watelet JB, Dhooge I. Uncommon and unusual complications of otitis media with effusion. Int J Pediatr Otorhinolaryngol 1999; 49 Suppl 1:S119-25. [PMID: 10577789 DOI: 10.1016/s0165-5876(99)00214-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Some complications of otitis media with effusion (OME) are not obvious and not always associated with otitis media by physicians and patients; the authors propose to call them 'unusual complications', although they may be quite frequent. Complications such as dizziness, clumsiness and behavioural disorders are classified in this group. Other complications are rare and uncommon such as sensorineural hearing loss and cholesteatoma. Some of these sequelae are structural, others more functional. The impact of OME on complex functions such as language, learning or behaviour is still controversial but seems to have been underestimated until now. Not only withholding treatment in children with OME may cause complications but also the treatment of OME may lead to sequelae, although serious side effects caused by the treatment of OME are rare. In this literature review, the epidemiology, importance and diagnosis of the uncommon and unusual complications of OME will be discussed.
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Affiliation(s)
- P van Cauwenberge
- Department of Otorhinolaryngology, University Hospital of Ghent, Belgium
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Indudharan R, Haq JA, Aiyar S. Antibiotics in chronic suppurative otitis media: a bacteriologic study. Ann Otol Rhinol Laryngol 1999; 108:440-5. [PMID: 10335703 DOI: 10.1177/000348949910800504] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Conservative medical management of chronic suppurative otitis media (CSOM) is an important step in achieving a dry ear. Topical antibiotic ear drops and aural toilet form the mainstay of medical management of noncholesteatomatous CSOM. This study analyzes the causal organisms and their sensitivity to various antibiotics. Out of 382 swabs examined, the major organisms isolated were Pseudomonas aeruginosa (27.2%), followed by Staphylococcus aureus (23.6%). The sensitivity of P. aeruginosa was 100% to ceftazidime, 98.9% to ciprofloxacin, 96.3% to gentamicin, and 95.4% to polymyxin B, whereas the sensitivity of S. aureus was 98.6% to ciprofloxacin, 97.4% to cloxacillin sodium, 96.5% to cotrimoxazole, and 90.7% to gentamicin. Pseudomonas aeruginosa was almost completely resistant to ampicillin (97.6%) and chloramphenicol (96.6%), whereas S. aureus was almost completely resistant to ampicillin (73.8%) and polymyxin B (98.3%). Among the available topical antibiotic preparations for use in the ear, we found that ciprofloxacin and gentamicin are the best choices.
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Affiliation(s)
- R Indudharan
- Department of Otorhinolaryngology, School of Medical Sciences, University Sains Malaysia, Kota Bharu
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Abstract
The etiology of cholesteatoma is still enigmatic. Of the current theories, none has been confirmed with adequately convincing evidence. A completely suitable animal model has not hitherto been available and there is still a need for further experimental studies of this entity. As a possible experimental model we suggest dimethyl-benzanthracene induced cholesteatoma in the rat.
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MESH Headings
- 9,10-Dimethyl-1,2-benzanthracene/adverse effects
- Animals
- Cholesteatoma, Middle Ear/chemically induced
- Cholesteatoma, Middle Ear/pathology
- Disease Models, Animal
- Ear Canal/drug effects
- Ear Canal/pathology
- Ear, Middle/drug effects
- Ear, Middle/pathology
- Epithelium/drug effects
- Epithelium/pathology
- Eustachian Tube/drug effects
- Eustachian Tube/pathology
- Keratins/drug effects
- Otitis Media, Suppurative/chemically induced
- Otitis Media, Suppurative/pathology
- Rats
- Rats, Sprague-Dawley
- Tympanic Membrane/drug effects
- Tympanic Membrane/pathology
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Affiliation(s)
- S H Schmidt
- Department of Otorhinolaryngology, University of Umeå, Sweden
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