Melanin capacity to accumulate drugs in the internal ear. A study on lidocaine, bupivacaine and chlorpromazine

The effect of lidocaine iontophoresis for the treatment of tinnitus: a systematic review

PURPOSE

Tinnitus is a common symptom with multiple causes and treatment options. Previous studies have investigated the effect of lidocaine iontophoresis. The aim of this review is to systematically present the effects on tinnitus and to derive possible effects.

METHODS

In accordance to the PRISMA statement, the search and analysis were performed. An abstract in German or English and a performed intervention with lidocaine iontophoresis for the treatment of tinnitus, independent of the study design, were considered as inclusion criteria. Due to the heterogeneity of the studies, only a narrative synthesis was performed.

RESULTS

The search yielded 179 studies of which 170 were excluded. Six full-texts and three abstracts were included. In total, 957 patients were treated with lidocaine iontophoresis. The percent improvement in symptoms after lidocaine iontophoresis ranged from 4% to 62%. The qualitative assessment of the studies resulted in an overall "weak" rating for all of them.

CONCLUSIONS

Due to the heterogeneity and the limited quality of the studies found, no clear statement can be made about the efficacy. The number of those who benefited from therapy varied widely. In addition, it cannot be ruled out that the effect was merely due to electrical stimulation of the cochlea.

The Role of Eye Color in the Emergence of Tinnitus in Silence

Introduction  Previous research suggests that African Americans are less likely than Caucasians to perceive tinnitus in sustained silence.

Objective  To evaluate the association between non-cutaneous melanin as indicated by eye color and the emergence of temporary tinnitus during a brief period of silence.

Methods  A cross-section of adults grouped according to their eye color were exposed to silence. A total of 62 adults, aged 18 to 35 years (10 males, 52 females) were required to sit in silence for 10 minutes, after which they filled out a questionnaire to report their eye color and any perception of sounds in the ears or head.

Results  In total, 63% of the participants perceived tinnitus while sitting in silence, and, of these 95% perceived the tinnitus sounds within 5 minutes of sitting in silence. Though African Americans were less likely to perceive tinnitus in silence, this difference was not significant ( p  = 0.6). After a period of silence, 69% of the subjects with light-colored eyes and 58% of the dark-eyed subjects perceived tinnitus. This difference was not statistically significant (χ ² (1) = 0.77; p  = 0.38).

Conclusion  When exposed to reduced auditory stimulation, 3 out of 5 normal-hearing people are likely to experience tinnitus. However, there was no relationship between eye color and the perception of tinnitus in silence. Although melanin has been shown to play a role in the protection of the ear against noise trauma and the effects of age-related hearing loss, its role in the emergence of tinnitus needs further investigation.

Melanin, the What, the Why and the How: An Introductory Review for Materials Scientists Interested in Flexible and Versatile Polymers

Today, western society is facing challenges to create new medical technologies to service an aging population as well as the ever-increasing e-waste of electronic devices and sensors. A key solution to these challenges will be the use of biomaterials and biomimetic systems. One material that has been receiving serious attention for its biomedical and device applications is eumelanin. Eumelanin, or commonly known as melanin, is nature's brown-black pigment and is a poly-indolequinone biopolymer, which possess unique physical and chemical properties for material applications. Presented here is a review, aimed at polymer and other materials scientists, to introduce eumelanin as a potential material for research. Covered here are the chemical and physical structures of melanin, an overview of its unique physical and chemical properties, as well as a wide array of applications, but with an emphasis on device and sensing applications. The review is then finished by introducing interested readers to novel synthetic protocols and post synthesis fabrication techniques to enable a starting point for polymer research in this intriguing and complex material.

Intravenously delivered aminoglycoside antibiotics, tobramycin and amikacin, are not ototoxic in mice

Many drugs on the World Health Organization's list of critical medicines are ototoxic, destroying sensory hair cells within the ear. These drugs preserve life, but patients can experience side effects including permanent hearing loss and vestibular dysfunction. Aminoglycoside ototoxicity was first recognised 80 years ago. However, no preventative treatments have been developed. In order to develop such treatments, we must identify the factors driving hair cell death. In vivo, studies of cell death are typically conducted using mouse models. However, a robust model of aminoglycoside ototoxicity does not exist. Previous studies testing aminoglycoside delivery via intraperitoneal or subcutaneous injection have produced variable ototoxic effects in the mouse. As a result, surgical drug delivery to the rodent ear is often used to achieve ototoxicity. However, this technique does not accurately model clinical practice. In the clinic, aminoglycosides are administered to humans intravenously (i.v.). However, repeated i.v. delivery has not been reported in the mouse. This study evaluated whether repeated i.v. administration of amikacin or tobramycin would induce hearing loss. Daily i.v. injections over a two-week period were well tolerated and transient low frequency hearing loss was observed in the aminoglycoside treatment groups. However, the hearing changes observed did not mimic the high frequency patterns of hearing loss observed in humans. Our results indicate that the i.v. delivery of tobramycin or amikacin is not an effective technique for inducing ototoxicity in mice. This result is consistent with previously published reports indicating that the mouse cochlea is resistant to systemically delivered aminoglycoside ototoxicity.

Implications of melanin binding in ocular drug delivery

Pigmented ocular tissues contain melanin within the intracellular melanosomes. Drugs bind to melanin at varying extent that ranges from no binding to extensive binding. Binding may lead to drug accumulation to the pigmented tissues and prolonged drug retention in the melanin containing cells. Therefore, melanin binding is an important feature that affects ocular drug delivery and biodistribution, but this topic has not been reviewed since 1998. In this review, we present current knowledge on ocular melanin, melanosomes and binding of drugs to pigmented cells and tissues. In vitro, in vivo and in silico methods in the field were critically evaluated, because the literature in this field can be confusing if the reader does not properly understand the methodological aspects. Literature analysis includes a comprehensive table of literature data on melanin binding of drugs. Furthermore, we aimed to give some insights beyond the current literature by making a chemical structure based classification model for melanin binding of drugs and kinetic simulations that revealed significant interplay between melanin binding and drug permeability across the melanosomal and plasma membranes. Overall, more mechanistic and systematic research is needed before the impact of melanin binding on ocular drug delivery can be properly understood and predicted.

Effects of a single high dose of cisplatin on the melanocytes of the stria vascularis in the guinea pig

The antineoplastic drug cisplatin is known to cause a reduction in endocochlear potential. The hypothesis to be tested was whether a single high dose of cisplatin affects the melanocytes by altering the expression of melanin. Pigmented guinea pigs received a bolus injection of cisplatin (8 mg/kg as a 15-second intravenous infusion). Auditory brainstem response (ABR) thresholds and morphological analysis of the hair cells and the stria vascularis were made 96 h after injection. ABR thresholds were elevated (15-40 dB) at 12-30 kHz and a significant loss of outer hair cells in the more basal regions was found. Cisplatin caused a significantly lower density of melanin in the intermediate cells in the basal region without any signs of apoptosis. Changes in melanin content were not noted in the middle or apical cochlear regions. Significant correlations were found between melanin density, ABR threshold shifts and outer hair cell loss in the region corresponding to 30 kHz. The findings reported here further support the multiple cytotoxic effect of cisplatin on the inner ear.

Quantitative differences in endolymphatic calcium and endocochlear potential between pigmented and albino guinea pigs

A number of previous studies have suggested that melanin may play a role in Ca2+ homeostasis of endolymph. In the present study, endolymph Ca2+ levels and endocochlear potential (EP) were measured in all four cochlear turns of pigmented or albino guinea pigs. Auditory sensitivity was also evaluated using cochlear action potential (AP) thresholds. In pigmented animals we found that endolymph Ca2+ tended to increase from base to apex of the cochlea, while EP systematically decreased towards the apex. In contrast, no significant Ca2+ gradient was found in albinos and the EP decline was far less. As a result, the apical turn of albino animals had significantly lower Ca2+ and significantly higher EP than in pigmented animals. AP thresholds pooled across all test frequencies were significantly lower in albino animals although no differences at individual frequencies reached significance. Even after correction for EP differences, the endolymph Ca2+ levels in albino animals were significantly lower than in pigmented ones. These results confirm that there are significant physiologic differences between pigmented and albino animals, which are a likely consequence of the absence of melanin in the albino cochlea. They are consistent with the involvement of melanin in the active transport of Ca2+ into endolymph.

The mechanism and site of action of lidocaine hydrochloride in guinea pig inner ear

Lidocaine was applied to the round window (RW) in order to localize its site of action in the cochlea. Cochlear microphonic (CM), summating potential (SP), and compound action potential (CAP) input/output functions were measured to a 16 kHz tone burst to assess the functional changes of the cochlea. In separate experiments, the effect of lidocaine on the whole cell current of isolated outer hair cells (OHC) was studied. A dose of 2 microliters of 40 mM lidocaine in saline solution, when applied to the RW, caused a small change in all measured variables, indicating a passage of the drug through the RW membrane to sites of action. However, 160 mM of lidocaine further decreased CM, SP, and CAP by a total of 40% from the control. A partial recovery occurred for CM during the 30 min follow-up period. CAP and SP continued to decline. In isolated OHCs, lidocaine decreased the whole cell current in a dose-dependent fashion. The KD for lidocaine effect on OHCs was 7 mM. Our in vivo results indicate that lidocaine affects OHCs and reduces CM, causing a subsequent reduction in SP and CAP. The increased effect of lidocaine on CAP and SP, while CM is recovering, suggests an additional specific effect of lidocaine on the cochlear nerve and/or on inner hair cells. Considering that lidocaine alters OHC current (in isolated hair cells) and that lidocaine does not affect endocochlear potential [Laurikainen et al. Acta Otolaryngol (Stockh) 1991: 112: 800-9], the observed CM changes are most likely due to an in vivo effect on OHCs. Thus, the early effect of lidocaine on the cochlea appears to be due to a significant change in organ of Corti function, rather than to direct anesthesia of the cochlear nerve. Later, an independent effect of the drug may occur on neural tissues in the inner ear.

Distribution and features of melanocytes during inner ear development in pigmented and albino rats

In this developmental study, the distribution and features of melanocytes in the inner ear of pigmented and albino rats was investigated with the use of an antibody, which specifically reacts with a melanocyte differentiation antigen present in the membranes of (pre)melanosomes. Melanocyte precursors could be traced from 13 days post conception onwards and the course was followed to their targets in the inner ear. Melanocytes which settle in the modiolus appeared to reach their target along another pathway than strial and vestibular melanocytes. No difference was observed in the melanocyte distribution between pigmented and albino rats. The integration of melanocytes into the stria vascularis was associated with an increased rate of melanosome production in both strains, but in the albinos far fewer melanosomes were produced. After the stria had reached maturity, melanosome production was arrested and melanosomes were subject to lysosomal digestion. In the stria of the pigmented rats, cells with aggregations of disintegrating melanosomes appeared and persisted into adulthood. In the adult, the majority of the intermediate cells contained only a few scattered melanosomes, while melanosomes could only rarely be detected in the albinos. These observations indicate that there is a close relationship between melanosome production and the process of interdigitation of melanocytes with the marginal cells. It seems unlikely that melanosomes or melanin make any important contribution to the function of the adult stria vascularis. Outside the stria, the features of melanocytes in both strains were similar to skin melanocytes.

Albino and pigmented gerbil auditory function: influence of genotype and gentamicin

Auditory function of albino and pigmented gerbils was examined before and after treatment with the ototoxic aminoglycoside antibiotic gentamicin. Auditory brainstem responses (ABRs) and cochlear nerve compound action potentials (CAPs) were measured in response to pure tones having frequencies between 2 and 32 kHz. Age-matched albinos had significantly lower CAP, but not ABR, thresholds than pigmented gerbils. Gentamicin treatment elevated CAP and ABR thresholds in both genotypes, but pigmented gerbils were less severely affected. Compared to the ABR, the CAP is a more sensitive measure of ototoxicity and pigmentation differences. CAP tuning curves (TCs) were another sensitive measure of genotypic differences in susceptibility to ototoxicity. TC tip thresholds from pigmented animals given gentamicin were not as elevated as the TC tip thresholds of albinos.

Turn-specific differences in the endocochlear potential between albino and pigmented guinea pigs

Recent findings indicate that structural differences exist in the stria vascularis (SV) between albino and pigmented guinea pigs. In the higher cochlear turns, volume density for marginal cells in the albino SV is abnormally large, while that for intermediate cells (melanocytes) is abnormally small. These anatomical variations suggest that functional differences between albino and pigmented inner ears also may be found. To examine this possibility, four strains of guinea pigs were studied, consisting of Hartley albino (N = 9) and NIH outbred pigmented (N = 15) guinea pigs, as well as albino (N = 11) and pigmented (N = 15) guinea pig siblings born to mixed litters. Tracheotomy and carotid artery cannulation were performed. Animals were mechanically ventilated, with periodic samples drawn for arterial blood gas analysis. Blood pressure, heart rate and rectal temperature were monitored. Compound action potentials were measured first to assess cochlear viability. Positive endocochlear potentials (+EP) then were recorded, beginning with the fourth turn, followed by the first, second and third turns. Results showed that the +EP in albinos remained relatively constant across cochlear turns, but decreased significantly from base to apex in the pigmented inner ears. Across all animals, mean +EPs (mV +/- S.E.M.) for turns 1-4 in albinos were: 72.5 (2.5), 68.7 (2.3), 59.2 (2.7), 68.1 (3.3); pigmented values were: 72.9 (2.9), 66.9 (2.6), 53.8 (3.0), 57.0 (2.7). One-way ANOVAs did not show a significant difference in albino +EPs between any of the cochlear turns, but did indicate a highly significant difference between turns in the pigmented inner ears (P < 0.000004). Post hoc comparisons demonstrated +EPs in turns 3 and 4 were smaller than in turn 1. Since turn 3 was recorded last in these experiments, and was reduced in value relative to turn 4 in both groups, it is likely that cochlear deterioration contributed to this result more than any other factor. These results, combined with previous anatomical data, indicate that a diminution of melanocyte cell volume in the albino SV is accompanied by an increase in marginal cell volume density and larger +EPs in the higher cochlear turns, at least at resting levels.

Experimental basis for lidocaine therapy in cochlear disorders

In order to further our basic understanding of the effects of lidocaine hydrochloride in the inner ear, cochlear potentials and blood flow (CBF) were assessed after intravenous (i.v.), anterior inferior cerebellar artery (AICA), and local round window (RW) lidocaine administrations in guinea pigs and rats. Lidocaine RW applications produced a dose dependent decrease in compound action potentials (CAP) and cochlear microphonics (CM). The sensitivity changes were more pronounced at high frequencies. These findings suggest that lidocaine has specific pharmacological action in the inner ear other than simple anesthesia of the auditory nerve. The basal turn endocochlear potentials (EP) were not altered by topical lidocaine, implicating altered organ of Corti function following local application of lidocaine. RW applications of lidocaine had no effect on CBF or systemic blood pressure (BP). I.v. infusions caused substantial reductions in BP. In the case of systemic infusions the percent changes in CBF were equal to and accountable by the BP changes. The microinfusions (50 mg/ml, 100 nl/min) through AICA produced a 30%, long lasting increase in CBF. However, neither systemic lidocaine nor AICA infusions had an effect on CAP or CM. These findings indicate that systemically given lidocaine may not cross the blood-cochlear barrier and that the cochlear electrophysiological effects due to lidocaine when given locally are partly mediated by direct influence on cochlear hair cell function; they also suggest that lidocaine-induced interference with active ion transport in the lateral wall or an influence on CBF are not contributing factors.

The function of melanin or six blind people examine an elephant

The pigment melanin is found in all living kingdoms and in many different structures and forms. When its various functions are examined separately, its behaviors seem disparate and conflicting. It has a clear role in camouflage and sexual display. Other major roles are examined critically. It can act as a sun screen but is not a very effective one. It can also scavenge active chemical species, but this, too, is not done very effectively. It produces active radicals that can damage DNA. It binds to drugs in ways that are either beneficial or deleterious. Aside from camouflage, its other roles can be brought together by a unifying hypothesis as first proposed by Proctor and McGinness nearly 20 years ago. Melanin is envisaged as an energy transducer with the properties of an amorphous semiconductor. It can absorb many different types of energy and dissipate them in the form of heat. However, if the energy input is too great, the output can be expressed in the form of activated chemical species that can damage cellular macromolecules resulting in cell death, mutations and cancer. The protective aspect of melanin in dark skin is seen as resulting from its high concentration and its confinement to ellipsoidal and densely packed organelles that can effectively shield the nucleus. In light skin, its radical nature is seen as potentially participating in the carcinogenic process, particularly when overwhelmed by intense episodes of sunburn.

Turn-specific and pigment-dependent differences in the stria vascularis of normal and gentamicin-treated albino and pigmented guinea pigs

The aims of the present study were to determine which structures in the stria vascularis (SV) may depend upon the presence of pigmented melanocytes both for normal morphology and for the expression of gentamicin ototoxicity in the inner ear. These pigment-dependent influences were inferred through comparisons of the SV in pigmented guinea pigs and in albinos containing nonpigmented melanocytes. Results were obtained from 6 albino and 8 pigmented guinea pigs given gentamicin, and from 3 albino and 3 pigmented control animals not receiving the drug. One-month old animals received gentamicin daily (100 mg/kg) for 14 days and recovered for an additional 14 days before being prepared for electron microscopy. The SV from each of the 4 cochlear turns was analyzed using stereological point counting procedures. In control animals, differences were found in the higher cochlear turns, where volume density for the marginal cells in albinos was abnormally large (turns 3 and 4), while the volume density for intermediate cells (melanocytes) was abnormally small (turn 3). Cell volume estimates for the intermediate cells were significantly smaller in the albino than pigmented control animals in the higher cochlear turns, indicating that functional abnormalities may be found in the albino cochlea. In animals exposed to gentamicin, marginal cell volume density was reduced significantly in turn 4 of albinos, but not in any region of the pigmented inner ears. Radial area of SV and estimates of the absolute volumes for marginal cells in albinos given gentamicin also were significantly reduced in turn 1 compared to their controls; such differences were not observed in the pigmented animals. The results indicate that marginal cell size is significantly reduced in albino but not pigmented animals 14 days after gentamicin exposure, and further suggest a role of pigmented melanocytes in ameliorating gentamicin-induced cochlear damage.

Ototoxicity of cis-platinum and its relationship to eye colour

The following hypothesis is presented: that the susceptibility of an individual patient to hearing loss as a result of cis-platinum administration can be predicted on the basis of eye colour. The rationale is that the melanin content of the inner ears is related to that of the eyes; dark eyes contain more melanin than light-coloured eyes; and melanin causes the accumulation of the ototoxic drug within the inner ear. Hence those with dark eyes will suffer greater damage to the hearing than those with pale eyes. An investigation that confirmed this hypothesis is reported. In addition to cochlear damage there is a significant likelihood of damage to the auditory nerve as a result of the treatment.

Gentamicin ototoxicity: histological and ultrastructural alterations after transtympanic administration

The histological and ultrastructural appearances of the inner ear vestibulum were studied after transtympanic administration of gentamicin in guinea-pigs. The animals were treated with a single transtympanic dose (0.2 cm3) of 4% gentamicin sulphate solution in the right ear; the left one was considered as control. After 7 days they were sacrificed and the vestibula of both inner ears were removed to be examined both by light and electron microscopy. In the treated inner ear damage was not always evident at light microscopical level, even if a case of complete disepithelialization of cristae ampullares was found. The examination by TEM revealed evident damage in the vestibular non-sensorial cells, such as severe cellular vacuolation, whereas sensorial elements presented heterochromatinic thickenings and cytoplasmic wrinkling, as compared to controls. The tunica fibrosa presented an irregular fibrillar plot, as well as that of the myelinic lamellae in the vestibular nerve fibres.

Melanin in the inner ear. An experimental study with control and kanamycin-intoxicated colored guinea-pigs

Following several studies on the effects of kanamycin toxicity on the inner ears of guinea pigs, we have studied the importance of melanin in this phenomenon. Transmission electron microscopy showed that, under the influence of kanamycin, the intermediate strial cells developed a secretory aspect similar to that seen in skin melanocytes. This aspect as yet has never been described for the inner ear cells. A planimetric, morphometric method was also used to determine the strial cell melanin status in control animals. Additional findings in the study confirmed an increase in the number of melanosomes during kanamycin poisoning. Statistical data are discussed.

Differential susceptibility to gentamicin ototoxicity between albino and pigmented guinea pigs

The known chemical affinity of melanin pigment for aminoglycoside antibiotics has led to the suggestion that higher concentrations of these drugs will bind to the pigmented inner ear and produce greater ototoxicity compared to the nonpigmented albino cochlea. Although this has provided a compelling hypothesis, results from the few investigations to address this question have been equivocal. In the present study, cochlear microphonic (CM) thresholds were recorded from albino and pigmented guinea pigs both before and two weeks after exposure for 14 consecutive days to 100 mg/Kg gentamicin. Cochleae were dissected and half-turn segments prepared for surface examination of the organ of Corti. After gentamicin exposure, threshold shifts averaged a statistically reliable 33 dB in albinos and 19 dB for the pigmented animals. Anatomical studies revealed a significant 44% mean outer hair cell loss in albinos compared to a 21% loss in the pigmented inner ears. The results showed that albinos display greater ototoxicity from gentamicin than do pigmented guinea pigs. Aminoglycosides are known to exert toxicity through interaction with polyphosphoinositides found in high concentrations in the inner ear. Cochleae in both albino and pigmented animals appear to possess significant phospholipid concentrations and bind toxic levels of these drugs independent of inner ear pigment content. However, evidence showing that melanin can inhibit aminoglycoside activity in vitro suggests that, once these drugs bind to pigmented tissue, they may undergo inactivation in a manner unavailable to the nonpigmented albino cochlea. The present results are consistent with the possibility that cochlear melanin may inhibit gentamicin activity in vivo and decrease the severity of aminoglycoside ototoxicity in the pigmented inner ear.

Effects of aging on normal hearing loss and noise-induced threshold shift in albino and pigmented guinea pigs

In a previous investigation into noise-induced hearing loss by comparing 2-month-old albino with pigmented guinea pigs, albinos displayed significantly greater shifts in cochlear microphonic (CM) threshold and less recovery than the pigmented animals 7 days after noise exposure. The present study compared the responses of 14-month-old albino and pigmented guinea pigs to the same noise parameters used previously. Thresholds for the first detectable elicitation of CM for three pure tones were recorded prior to, at 90 min and at 7 days after a 45-min exposure to 126 dB broadband noise. Before exposure to noise, thresholds for pigmented guinea pigs were 24 dB higher than those in the albinos. Following noise exposure, the pigmented animals showed less than half the amount of threshold shift displayed by the albinos. This change ws attributed to the higher pre-exposure thresholds in the pigmented guinea pigs. Converging lines of evidence suggest that cochlear pigmentation may have both protective and toxic influences on the inner ear.

Extra-cutaneous melanin

Extra-cutaneous melanocytes derive from either the neural crest, the outer wall of the optic cup, or the cranial neural tube. Those of neural crest origin reach most bodily regions, and may give rise to primary melanoma in various tissues. The Kupffer cell produces a form of melanin, but is hardly a melanocyte. Melanocytes of the internal ear may be concerned with secretion of endolymph, trans-epithelial ion transport, and with protection against ototoxic drugs and high-intensity noise damage. There is evidence from albino animals that retinal pigment epithelium determines co-ordinates of the neural retina, and its decussation pattern during development. Neuromelanin derives from Dopamine, and is found in dopaminergic neurons widely distributed throughout the brain-stem and hypothalamus, and which project to the striatum and limbic system. Parkinsonism is due to degeneration of melanin-containing dopaminergic neurons of locus coeruleus and substantia nigra, and MPTP provides an investigative probe for studying the causes of Parkinsonism. Neuromelanin should not be regarded as a waste-product, but as something which can affect the firing properties of neurons with specific functional effect.

Trimethyltin ototoxicity in albino rats

The toxicity of alkyltin compounds is of exceptional interest due to the dissimilar toxic effects of some very closely related structural analogues among this class of compounds. Since several features of the toxicity of trimethyltin appeared to be consistent with a mechanism involving accumulation of the toxicant on melanin pigments, the ototoxicity induced by TMT exposure was examined in albino rats. Hearing thresholds for tones sampling the mid- and high-frequency range of the rat's audibility function were assessed by reflex inhibition audiometry. TMT produced a frequency dependent loss of auditory sensitivity that was most severe in the high frequency range. The TMT-induced impairment of auditory function was similar to that previously observed in pigmented Long-Evans rats. These results extend the observation of TMT-induced hearing loss to a non-pigmented rodent strain and suggest that the accumulation of TMT on cochlear melanin is not critical to the production of hearing impairment by TMT.

Cis-platin ototoxicity in previously noise-exposed guinea pigs

The ototoxic effect of Cis-platin on guinea pigs was assessed with frequency-specific brainstem audiometry in the frequency range 0.8-20 kHz. The animals had a noise-induced hearing loss in one ear before Cis-platin treatment. The loss of threshold showed a large inter-individual variability, with a rapid increase above a hypothetic threshold dose. In the noise-exposed ear the total loss was larger, but the additional ototoxic effect was smaller than on the non-exposed side. The hearing loss was independent of pigmentation. in conclusion, there is no potentiation between noise-induced hearing loss and Cis-platin. The data support regular audiometric control before and during Cis-platin treatment for easy detection of incipient hearing loss, before the speech frequency range is affected.

The ototoxic effects of different doses of gentamicin on the cochlea of pigmented guinea pigs

The aims of this study were twofold: to obtain baseline data on gentamicin ototoxicity in the pigmented guinea pig, and to compare this data with an earlier study in the albino guinea pig. Animals were given ten consecutive daily doses, subcutaneously, of gentamicin at either 50, 75 or 100 mg/kg. Control animals received equivalent volumes of saline. After 3 weeks the animals were killed and their cochleae examined by light microscopy for hair cell damage. Hair cell damage was mapped onto cochleograms and subsequently quantified. Three sets of comparisons of hair cell damage were made: gentamicin group versus control group for each dose; comparisons between doses; pigmented animals versus albino animals. It was found that cochlear hair cell damage increased with increasing dose of gentamicin: 50 mg/kg was minimally ototoxic, 75 mg/kg was more ototoxic and 100 mg/kg was highly ototoxic, affecting a large extent of the spiral organ. There was a large (statistically significant) difference between the lower doses and the damage caused by 100 mg/kg. The pigmented-albino animal comparison showed albino guinea pigs to be more susceptible to gentamicin.

Results of an ultrastructural study comparing stria vascularis with organ of Corti in guinea pigs treated with kanamycin

Ultrastructural study of ototoxicity is well documented with two points of interest: organ of Corti for aminoglycosides and stria vascularis for loop diuretics. As a previous study suggested initial lesions of stria vascularis, an attempt of comparison and of chronological study was made between the organ of Corti and stria vascularis lesions by kanamycin intoxication. The method was devised by J. M. ARAN, with electrophysiological control. We failed to find in the stria vascularis a radial or longitudinal pattern of lesions. We could not discern a chronological injury between the organ of Corti and stria vascularis because both were damaged even in the less deafened animals. Nevertheless, two facts were clarified: hair cell lesions are lysosomial as for the kidney lesions, while stria vascularis lesions are mitochondrial, melanine granulations play a part in drug metabolism (increased number, secretory aspect) and deserve further study.

The questionable relation between cochlear pigmentation and noise-induced hearing loss

Some evidence has suggested that susceptibility to noise-induced hearing loss may be inversely proportional to the amount of melanin in the cochlea. However, published data have not been consistent in demonstrating this relation, and some results may be contaminated by lack of genetic control in experimental animals. In this investigation, noise-induced hearing loss was evaluated in pigmented and albino C57BL/6J mice that differed only in their ability to produce melanin. Surface-recorded electric responses to sound were used to assess auditory sensitivity. Results indicated no difference between the two groups either in pre-exposure thresholds or in magnitude of noise-induced threshold shift.

Auditory brainstem-evoked response after single-dose injection of lidocaine and tocainide

In order to investigate the effects of tocainide and lidocaine on the auditory brainstem-evoked response (ABR), 10 healthy male subjects 20-40 years of age were given a single i.v. dose of 250 mg of tocainide and of 100 mg of lidocaine on separate occasions in a trial with a double-blind cross-over design. Neither drug produced any significant change in absolute or interpeak intervals, or in latency-intensity functions (wave V). The results fail to indicate that lidocaine and tocainide in the doses given influence the synaptic transmission and conduction velocity in the cochlear nerve or in the brainstem.

Psychological treatment of tinnitus. An experimental group study

Twenty-four patients with moderately severe (grade 2) to severe (grade 3) subjective tinnitus participated in an experimental group study. The patients were randomly assigned to a treatment group and a waiting-list control group. Treatment was given with a coping technique and comprised 10 one-hour sessions. Following a corresponding period without treatment, the control group was treated similarly. Daily self-recording of the subjective tinnitus loudness, the discomfort from the tinnitus, depression and irritation was performed before and after treatment. In addition, psychoacoustic measurement was undertaken on three occasions. The treatment group improved significantly more than the waiting-list control group. After treatment of the latter group, combined data of both groups showed statistically significant improvements in all variables. The results show that tinnitus annoyance can be treated by psychological methods.

Use of albino animals for auditory research

Since Hearing Research commenced publication, 51% of reports involving the use of guinea pigs provide no information on whether the animals used were albino or pigmented. Recent evidence creates a strong suspicion that the albino mutation can influence both peripheral and central auditory function. It is concluded that information on pigmentation should always be provided in reports of auditory experiments on guinea pigs, and that the only justification for using albino animals in auditory research is to study effects of the albino mutation on hearing.

The relations of eye colour and smoking to noise-induced permanent threshold shift

The hearing of 118 otologically normal soldiers 40 years of age or less with at least 8 years service was tested. Their eye colours were also recorded. Each soldier was questioned concerning his medical history, history of noise exposure and smoking habits. Left ear average hearing levels at 3 kHz were poorer in soldiers with eye colours indicating no melanin pigmentation of the iris than those with iris pigmentation (p < 0.05). Effects of smoking were statistically significant at one frequency but difficult to interpret in terms of current theories.

Kanamycin ototoxicity and pigmentation in the guinea pig

Cochleas from albino and pigmented guinea pigs were examined histologically following chronic administration of Kanamycin. In pigmented animals, damage was concentrated amongst hair cells towards the base, but in albinos, hair cell damage was diffusely spread. These observations support suggestions that melanin is implicated in Kanamycin ototoxicity.

The sensitivity of cochlear albino melanocytes to horseradish peroxidase

The effects of low concentrations (0.5%--0.0005%) of HRP and varying postperfusion survival times (5.5 hours--15 seconds) on cochlear albino melanocytes were studied by light and electron microscopy. Approximately 50 microliter of differing concentrations of HRP dissolved in artificial perilymph were perfused through the perilymphatic space in 32 albino guinea pigs. Tissues were subsequently treated histochemically to demonstrate HRP reaction product. The results indicate that concentrations of HRP > 0.0005% in combination with postperfusion survival times > 1 hour bring about acute and selective injury to the albino melanocytes; cytoplasmic vacuolization and rupture of cell membranes occurred. The structural integrity of the albino melanocytes appeared unaltered when exposed to 0.0005% concentrations of HRP for less than or equal to 1 hour. An apparently non-toxic 0.0005% concentration of HRP may provide a means of labeling cochlear melanocytes when the effects of other substances on the cells are investigated.

Some otological differences between pigmented and albino-type guinea pigs

Cochlear action potential thresholds across frequency (AP audiograms) and AP tuning curves were compared in albino (Dunkin-Hartley) guinea pigs and normal pigmented animals. AP audiograms were very similar; on average the albinos had AP thresholds 2-3 dB lower at 2 kHz and below compared with the pigmented guinea pig. AP tuning curves at 16 kHz were, on average, significantly less sharply tuned in the albino, but similar at 8, 4, and 2 kHz. Although we find only small differences in these measures of normal cochlear function, other evidence in the literature suggests that in auditory research the use of "albino" guinea pigs is best avoided.