Effect of topical dexamethasone versus rimexolone on middle ear inflammation in experimental otitis media with effusion

Florea, Andrew S.; Zwart, Jon E.; Lee, Choong Won; Depew, Aron; Park, Seong Kook; Inman, Jared C.; Wareham, Rachelle; K, Johnson; John, E. O.; Wall, G. Michael; Jung, Timothy K.

doi:10.1080/00016480600606699

Cited by 12 publications

(8 citation statements)

References 20 publications

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“…Compared with the normal control, LPS-treated animals showed a thicker tympanic membrane and mucosa of the middle ear. A large population of inflammatory cells was found in the vicinity of the tympanic membrane and middle ear mucosa ( Fig 1E and 1F ), indicating an acute otitis media consistent with reports of others [ 44 – 46 ]. LPS-treated animals also showed morphological changes in the intra-strial fluid-blood barrier.…”

Section: Discussionsupporting

confidence: 89%

Lipopolysaccharide-Induced Middle Ear Inflammation Disrupts the cochlear Intra-Strial Fluid–Blood Barrier through Down-Regulation of Tight Junction Proteins

et al. 2015

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Middle ear infection (or inflammation) is the most common pathological condition that causes fluid to accumulate in the middle ear, disrupting cochlear homeostasis. Lipopolysaccharide, a product of bacteriolysis, activates macrophages and causes release of inflammatory cytokines. Many studies have shown that lipopolysaccharides cause functional and structural changes in the inner ear similar to that of inflammation. However, it is specifically not known how lipopolysaccharides affect the blood-labyrinth barrier in the stria vascularis (intra-strial fluid–blood barrier), nor what the underlying mechanisms are. In this study, we used a cell culture-based in vitro model and animal-based in vivo model, combined with immunohistochemistry and a vascular leakage assay, to investigate lipopolysaccharide effects on the integrity of the mouse intra-strial fluid–blood barrier. Our results show lipopolysaccharide-induced local infection significantly affects intra-strial fluid–blood barrier component cells. Pericytes and perivascular-resident macrophage-like melanocytes are particularly affected, and the morphological and functional changes in these cells are accompanied by substantial changes in barrier integrity. Significant vascular leakage is found in the lipopolysaccharide treated-animals. Consistent with the findings from the in vivo animal model, the permeability of the endothelial cell monolayer to FITC-albumin was significantly higher in the lipopolysaccharide-treated monolayer than in an untreated endothelial cell monolayer. Further study has shown the lipopolysaccharide-induced inflammation to have a major effect on the expression of tight junctions in the blood barrier. Lipopolysaccharide was also shown to cause high frequency hearing loss, corroborated by previous reports from other laboratories. Our findings show lipopolysaccharide-evoked middle ear infection disrupts inner ear fluid balance, and its particular effects on the intra-strial fluid–blood barrier, essential for cochlear homeostasis. The barrier is degraded as the expression of tight junction-associated proteins such as zona occludens 1, occludin, and vascular endothelial cadherin are down-regulated.

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Section: Discussionsupporting

confidence: 89%

Lipopolysaccharide-Induced Middle Ear Inflammation Disrupts the cochlear Intra-Strial Fluid–Blood Barrier through Down-Regulation of Tight Junction Proteins

et al. 2015

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“…They have also suggested that their results support to the current use of anti-inflammatory ototopical in the treatment of inflammatory middle ear disease such as corticosteroids, avoiding systemic side effects [13,20]. It has also shown that combination therapy including dexamethasone has been to be more effective than antibiotic alone in the treatment of acute otitis media and otorrhea through a patent tympanostomy tube.…”

Section: Discussionsupporting

confidence: 52%

Effectiveness of Intratympanic Dexamethasone in Otitis Media with Effusion Resistant to Conventional Therapy

Paksoy¹,

Altın²,

Eken³

et al. 2011

Indian J Otolaryngol Head Neck Surg

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The aim of this study was to determine the efficiency of intratympanic dexamethasone (ITD) injections as a new treatment modality in otitis media with effusion resistant to conventional therapy. We planned a nonrandomized prospective study to determine the safety and effectiveness of the direct administration of dexamethasone into middle ear cavity with chronic eustachian tube dysfunction. This study was applied on 75 ears of 64 patients aged from 12 to 60 years. ITD received 47 ears of 41 patients who had previously been treated by medical or surgical therapy middle ear effusion without resolution classified as study group. They were taken conventional medical therapy again 28 ears of 23 patients classified as a control group. ITDs were administered 0.5 ml/4 mg per mm directly in antero-superior quadrant of tympanic membrane. These injections were repeated once a week for 4 weeks. Results were evaluated by using audiometric and tympanometric measurements 1 and 3 months after the treatments. Audiometric measurement shows that 9.91 dB improvement in the mean air-bone gap 15.17 dB in air conduction (AC) pure-tone averages (PTA) and 5.25 dB bone conduction (BC) PTA. But the control group data showed only 2 dB improvement in the mean air-bone gap, 3 dB AC-PTA and 1.36 dB BC-PTA. Tympanometric improvement was found. In 28 ears of patients (59.6%) like type B or C converted to type A in study group without complication but only in three ears (10.7%) of control group. ITD administration to the middle ear is safe and effective for the treatment of otitis media with effusion or chronic eustachian tube dysfunction. No complications like tympanic membrane perforation and/or sensorineural hearing loss have occurred.

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“…Glucocorticoids were included in the treatment protocol, both topically and systemically, as they have been shown to reduce mucus production (Florea et al . 2006, Wang et al . 2007, Macarthur et al .…”

Section: Discussionmentioning

confidence: 99%

Otitis media with effusion in the boxer: a report of seven cases

Paterson

2017

J of Small Animal Practice

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The aim of this study was to describe otitis media with effusion in seven boxers. All dogs presented with a range of clinical signs, which included head shaking, neurological dysfunction, pain on opening of the mouth and reduction in hearing ability. Otitis media was confirmed under general anaesthesia in each case by video-otoscopic identification of a bulging pars tensa and subsequent myringotomy, which revealed a tenacious mucus plug within the middle ear. Brainstem auditory evoked response thresholds were elevated in all affected ears. In three cases, CT revealed soft tissue opacity in the affected bulla. All of the affected middle ears were flushed using warm sterile saline to remove the mucus. A combination of glucocorticoid and antibiotic in EDTA tris was instilled into the middle ears. After the initial middle ear flush under general anaesthesia, topical therapy was applied into the ear canals daily by the owners using the same combination of drugs. Dembrexine, a systemic mucolytic, was administered with food daily. Six out of seven dogs were also prescribed oral prednisolone. In each case, the middle ear effusion was sterile. All clinical signs resolved with treatment, with the exception of facial paralysis in two dogs. Otitis media with effusion should be considered a cause of otitis media in boxers.

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Effect of topical dexamethasone versus rimexolone on middle ear inflammation in experimental otitis media with effusion

Cited by 12 publications

References 20 publications

Lipopolysaccharide-Induced Middle Ear Inflammation Disrupts the cochlear Intra-Strial Fluid–Blood Barrier through Down-Regulation of Tight Junction Proteins

Lipopolysaccharide-Induced Middle Ear Inflammation Disrupts the cochlear Intra-Strial Fluid–Blood Barrier through Down-Regulation of Tight Junction Proteins

Effectiveness of Intratympanic Dexamethasone in Otitis Media with Effusion Resistant to Conventional Therapy

Otitis media with effusion in the boxer: a report of seven cases

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