Corticosteroids in Otorhinolaryngology

Skarżyńska, Magdalena Beata; Skarżyński, Henryk

doi:10.5772/intechopen.98636

Cited by 4 publications

(3 citation statements)

References 55 publications

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“… 16 Dexamethasone's effectiveness has been associated with its anti‐inflammatory mechanisms within the labyrinth, Na + ion control, and osmotic homeostasis. 17 …”

Section: Introductionmentioning

confidence: 99%

“…16 Dexamethasone's effectiveness has been associated with its anti-inflammatory mechanisms within the labyrinth, Na + ion control, and osmotic homeostasis. 17 However, research on the efficacy of using corticosteroids during stapedotomy to reduce postoperative dizziness has been limited. Therefore, the objective of this study was to assess the impact of topical administration of dexamethasone on the middle ear during stapedotomy on post-stapedotomy dizziness.…”

Section: Introductionmentioning

confidence: 99%

“…Additionally, studies showed that intratympanic dexamethasone has a 47%–91% efficacy rate in reducing vertigo in patients with Meniere disease 16 . Dexamethasone's effectiveness has been associated with its anti‐inflammatory mechanisms within the labyrinth, Na + ion control, and osmotic homeostasis 17 …”

Section: Introductionmentioning

confidence: 99%

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Post‐stapedotomy dizziness after applying topical steroid on footplate: A randomized controlled trial

Barati,

Shahzamani,

Tabrizi

et al. 2024

Laryngoscope Investig Oto

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BackgroundOtosclerosis is characterized by abnormal bone growth in the otie capsule. Nowadays, stapedotomy is commonly used for otosclerosis treatment. Currently, postoperative dizziness has been associated with stapedotomy. In 1981, intratympanic dexamethasone was utilized to manage inner ear disorders like tinnitus and acute sensorineural hearing loss. However, there is much uncertainty regarding the effect and safety of topical steroid therapy in the middle ear during stapedotomy. In the present study, we assessed the effect of topical steroid therapy during stapedotomy on postoperative dizziness.MethodsOtosclerosis patients eligible for stapedotomy were randomly divided into two groups based on dexamethasone administration or placebo. Audiometric and tympanometry results were observed and recorded for the involved frequencies. The Dizziness Handicap Inventory was used to quantify patient perceptions of dizziness and balance issues. Audiometry and dizziness assessments were repeated at discharge and 4 months after the operation.ResultsThe study comprised 72 otosclerosis patients undergoing stapedotomy. At discharge, the intervention group showed a significant reduction in the incidence of dizziness compared to the placebo group. However, in the 4‐month follow‐up after the operation, both groups experienced a decrease in dizziness incidence, with no significant difference between them. There was also no significant difference in audiometric levels between the two groups. Interestingly, the intervention group had a significantly lower need for systemic anti‐dizziness drugs after surgery compared to the control group.ConclusionTopical dexamethasone during stapedotomy effectively minimizes dizziness at discharge and reduces the need for postoperative anti‐dizziness medication.Level of evidence2.

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“… 16 Dexamethasone's effectiveness has been associated with its anti‐inflammatory mechanisms within the labyrinth, Na + ion control, and osmotic homeostasis. 17 …”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Post‐stapedotomy dizziness after applying topical steroid on footplate: A randomized controlled trial

Barati,

Shahzamani,

Tabrizi

et al. 2024

Laryngoscope Investig Oto

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Protection of lipopolysaccharide-induced otic injury by a single dose administration of a novel dexamethasone formulation

Murillo-Cuesta,

Lara,

Bermúdez-Muñoz

et al. 2023

transl med commun

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Background The blood-labyrinth barrier (BLB) separates the inner ear from the circulation and is critical for maintaining ionic homeostasis and limiting the entry of deleterious agents. BLB integrity is disrupted by bacterial lipopolysaccharide (LPS), which elicits a strong inflammatory response in the inner ear leading to irreversible otic damage. Prolonged administration of systemic corticosteroids is the available treatment, but it shows both limited efficacy and major adverse effects. SPT-2101 is a novel in situ-forming gel formulation of dexamethasone allowing slow and sustained drug release after single intratympanic administration. Methods We used a rat model of LPS-induced injury to define the functional, cellular and molecular mechanisms associated to BLB dysfunction and the protection by SPT-2101. Hearing was assessed by auditory brainstem response (ABR) recording, BLB permeability by gadolinium dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and Evans blue extravasation. Gross cochlear histology and cellular alterations were studied by hematoxylin-eosin staining and immunofluorescence. RT-qPCR, PCR array and western blotting were used to assess transcriptional and protein changes. Results LPS-challenged rats showed BLB breakdown and altered permeability as shown by the progressive increase in cochlear gadolinium uptake and Evans blue incorporation. LPS administration increased the cochlear expression of the LPS toll-like receptors Tlr2 and co-receptor Cd14, pro-inflammatory cytokines and receptors such as Il1b and ll1r1, and also the oxidative stress and inflammasome mediators NRF2 and NLRP3. LPS also increased IBA1-positive macrophage infiltration in the lateral wall and spiral ganglion. A single intratympanic injection of SPT-2101 protected BLB integrity and prevented otic injury. Comparable effects were obtained by repeated administration of systemic dexamethasone, but not by a single dose. SPT-2101 administration normalized molecular inflammatory mediators and suppressed macrophage infiltration. Conclusions Our data indicate that single local administration of dexamethasone formulated as SPT-2101 protects BLB functional integrity during endotoxemia, providing a novel therapeutic opportunity to treat diseases related to BLB dysfunction.

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Protection of lipopolysaccharide-induced otic injury by a single dose administration of a novel dexamethasone formulation

Murillo-Cuesta,

Lara,

Bermúdez-Muñoz

et al. 2023

Preprint

View full text Add to dashboard Cite

Background. The blood-labyrinth barrier (BLB) separates the inner ear from the circulation and is critical for maintaining ionic homeostasis and limiting the entry of deleterious agents. BLB integrity is disrupted by bacterial lipopolysaccharide (LPS), among other deleterious agents, which elicits a strong inflammatory response in the inner ear leading to irreversible otic damage. Prolonged administration of systemic corticosteroids is the available treatment, which shows both limited efficacy and major adverse effects. SPT-2101 is a novel in situ-forming gel formulation of dexamethasone allowing slow and sustained drug release after single intratympanic administration. Methods. We used a rat model of LPS-induced injury to define the functional, cellular and molecular mechanisms associated to BLB dysfunction and the protection by SPT-2101. Hearing was assessed by auditory brainstem response (ABR) recording, BLB permeability by gadolinium dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and Evans blue extravasation. Gross cochlear histology and cellular alterations were studied by hematoxylin-eosin staining and immunofluorescence. RT-qPCR, PCR array and western blotting were used to assess transcriptional and protein changes. Results. LPS-challenged rats showed BLB breakdown and altered permeability as shown by the progressive increase in cochlear gadolinium uptake and Evans blue incorporation. LPS administration increased the cochlear expression of the LPS toll-like receptors Tlr2 and co-receptor Cd14, pro-inflammatory cytokines and receptors such as Il1b and ll1lr, and also the oxidative stress and inflammasome mediators NRF2 and NLRP3. LPS also increased IBA1-positive macrophage infiltration in the lateral wall and spiral ganglion. A single intratympanic injection of SPT-2101 protected BLB integrity and prevented otic injury. Comparable effects were obtained by repeated administration of systemic dexamethasone, but not by a single dose. SPT-2101 administration normalized molecular inflammatory mediators and suppressed macrophage infiltration. Conclusions. Our data indicate that single local administration of dexamethasone formulated as SPT-2101 protects BLB functional integrity during endotoxemia, providing a novel therapeutic opportunity to treat diseases related to BLB dysfunction.

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Corticosteroids in Otorhinolaryngology

Cited by 4 publications

References 55 publications

Post‐stapedotomy dizziness after applying topical steroid on footplate: A randomized controlled trial

Post‐stapedotomy dizziness after applying topical steroid on footplate: A randomized controlled trial

Protection of lipopolysaccharide-induced otic injury by a single dose administration of a novel dexamethasone formulation

Protection of lipopolysaccharide-induced otic injury by a single dose administration of a novel dexamethasone formulation

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