Gentamicin and other ototoxic antibiotics for the transtympanic treatment of Meni�re's disease

Lange, G.

doi:10.1007/bf00463571

Cited by 53 publications

(46 citation statements)

References 3 publications

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“…However, such information cannot be directly applied to clinical application unless appropriate delivery techniques and treatment regimes have been established. 8 Intratympanic delivery of drugs to the inner ear via RWM was introduced more than half a century ago for the treatment of Ménière's disease with local anesthetics and antibiotics 27,28 and has been widely used in clinics since the 1990s. 29 Therefore, administration of neurotrophic factors through the RWM offers an alternative technique for less invasive delivery of therapeutic molecules to the cochlea, based upon its permeability.…”

Section: Discussionmentioning

confidence: 99%

Enhanced bioavailability of nerve growth factor with phytantriol lipid-based crystalline nanoparticles in cochlea

Tang

Wei

et al. 2015

IJN

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Purpose Supplementation of exogenous nerve growth factor (NGF) into the cochlea of deafened animals rescues spiral ganglion cells from degeneration. However, a safe and potent delivery of therapeutic proteins, such as NGF, to spiral ganglion cells remains one of the greatest challenges. This study presents the development of self-assembled cubic lipid-based crystalline nanoparticles to enhance inner ear bioavailability of bioactive NGF via a round window membrane route. Methods A novel nanocarrier-entrapped NGF was developed based on phytantriol by a liquid precursor dilution, with Pluronic ® F127 and propylene glycol as the surfactant and solubilizer, respectively. Upon dilution of the liquid lipid precursors, monodispersed submicron-sized particles with a slight negative charge formed spontaneously. Results Biological activity of entrapped NGF was assessed using pheochromocytoma cells with NGF-loaded reservoirs to induce significant neuronal outgrowth, similar to that seen in free NGF-treated controls. Finally, a 3.28-fold increase in inner ear bioavailability was observed after administration of phytantriol lipid-based crystalline nanoparticles as compared to free drug, contributing to an enhanced drug permeability of the round window membrane. Conclusion Data presented here demonstrate the potential of lipid-based crystalline nanoparticles to improve the outcomes of patients bearing cochlear implants.

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Section: Discussionmentioning

confidence: 99%

Enhanced bioavailability of nerve growth factor with phytantriol lipid-based crystalline nanoparticles in cochlea

Tang

Wei

et al. 2015

IJN

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“…Intratympanic aminoglycosides have long been known to be effective in controlling vertigo due to Me Ânie Áre's disease. Schuknecht (using streptomycin) and Lange (using gentamicin) gave multiple intratympanic injections of these antibiotics each day until patients developed dysequilibrium or until caloric responses were abolished (Schuknecht 1957;Lange 1976Lange , 1989Lange , 1995a. Vertigo was controlled in most of these patients (100% in Schuknecht's series; 88% in Lange's), but the rates of sensorineural hearing loss attributed to the aminoglycosides were unacceptably high (62% and 48%, respectively).…”

Section: Introductionmentioning

confidence: 99%

Changes in the Three-Dimensional Angular Vestibulo-Ocular Reflex following Intratympanic Gentamicin for Ménière's Disease

Carey

Minor

Peng

et al. 2002

JARO - Journal of the Association for Research in Otolaryngolog

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The 3-dimensional angular vestibulo-ocular re¯exes (AVOR) elicited by rapid rotary head thrusts were studied in 17 subjects with unilateral Me Ânie Áre's disease before and 2±10 weeks after treatment with intratympanic gentamicin and in 13 subjects after surgical unilateral vestibular destruction (SUVD). Each head thrust was in the horizontal plane or in either diagonal plane of the vertical semicircular canals, so that each head thrust effectively stimulated only one pair of canals. The AVOR gains (eye velocity/head velocity during the 30 ms before peak head velocity) for the head thrusts exciting each individual canal were averaged and taken as a measure of the function of that canal. Prior to intratympanic gentamicin, gains for head thrusts that excited canals on the affected side were 0.91 0.20 (horizontal canal, HC), 0.78 0.20 (anterior canal, AC), and 0.83 0.10 (posterior canal, PC). The asymmetries between these gain values and those for head thrusts that excited the contralateral canals were <2%. In contrast, caloric asymmetries averaged 40% 32%. Intratympanic gentamicin resulted in decreased gains attributable to each canal on the treated side: 0.40 0.12 (HC), 0.35 0.14 (AC), 0.31 0.14 (PC) (p < 0.01). However, the gains attributable to contralateral canals dropped only slightly, resulting in marked asymmetries between gains for excitation of ipsilateral canals versus their contralateral mates: HC: 34% 12%, AC: 24% 25%, and PC: 42% 13%. There was no difference in the AVOR gain for excitation of the ipsilateral HC after gentamicin in patients who received a single intratympanic injection (0.39 0.11, n = 12) in comparison to those who received 2±3 injections (0.42 0.15, n = 5, p = 0.7). Gain decreases attributed to the gentamicintreated HC and AC were not as severe as those observed after SUVD. This ®nding suggests that intratympanic gentamicin causes a partial vestibular lesion that may involve preservation of spontaneous discharge and/or rotational sensitivity of afferents.

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“…The disabling symptoms of vertigo in Ménière's disease may be treated with intratympanic (IT) injections of the ototoxic aminoglycoside gentamicin [Lange, 1989;Chia et al, 2004;Cohen-Kerem et al, 2004].…”

Section: Introductionmentioning

confidence: 99%

Vestibular Function and Vertigo Control after Intratympanic Gentamicin for Ménière’s Disease

Nguyen

Minor²,

Santina

et al. 2009

Audiol Neurotol

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The aim of this study was to correlate long-term vertigo control with reduction in vestibular function after intratympanic (IT) gentamicin therapy for unilateral Ménière’s disease. IT gentamicin injections were given as needed to control vertigo attacks. Vertigo frequency and changes in angular vestibulo-ocular reflex (AVOR) gain (measured using magnetic search coils and manual head thrusts) and caloric weakness were assessed before and after treatment. Better vertigo control after treatment was found with ≥60% reduction in quantitative ipsilateral horizontal semicircular canal AVOR gain from pre-treatment values and/or with caloric unilateral weakness (UW) >50%. However, no correlations were found between the continuous variables of vertigo control and either gain or gain recovery, nor between gain and UW because of the large variability in vertigo control in subjects with lesser reductions in these measures.

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Gentamicin and other ototoxic antibiotics for the transtympanic treatment of Meni�re's disease

Cited by 53 publications

References 3 publications

Enhanced bioavailability of nerve growth factor with phytantriol lipid-based crystalline nanoparticles in cochlea

Enhanced bioavailability of nerve growth factor with phytantriol lipid-based crystalline nanoparticles in cochlea

Changes in the Three-Dimensional Angular Vestibulo-Ocular Reflex following Intratympanic Gentamicin for Ménière's Disease

Vestibular Function and Vertigo Control after Intratympanic Gentamicin for Ménière’s Disease

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