Hydrocortisone Applied into the Round Window Niche Causes Electrophysiological Dysfunction of the Inner Ear

Spandow, Odd; Anniko, Matti; Hellström, Sten

doi:10.1159/000276040

Cited by 41 publications

(30 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…ABRs did not recover until 8 weeks after application. Morphological intracochlear damage as assessed by light and transmission electron microscopy was not observed [150].…”

Section: Glucocorticoids Applied Locally Onto the Round Window Membranementioning

confidence: 86%

How Useful Is Corticosteroid Treatment in Cochlear Disorders?

Lamm¹,

Arnold²

1999

Otorhinolaryngol Nova

View full text Add to dashboard Cite

The scientific basis for the administration of corticosteroids classified as glucocorticoids in certain cochlear disorders, such as immune-mediated progressive and idiopathic acute sensorineural hearing loss (SNHL), Ménière’s disease and noise-induced hearing loss (NIHL), was discussed. The current knowledge on the physiological functions of endogenous glucocorticoids and the pharmacological effects of their synthetic analogs was summarized. Emphasis was placed on experimental studies on corticosteroids in the cochleovestibular system and on the therapeutic effects of glucocorticoids on SNHL, Ménière’s disease, NIHL and chronic tinnitus obtained from clinical trials. Glucocorticoids exert numerous profound effects on almost every organ system, including mechanisms involved in anti-inflammatory action and immunosuppression. However, inflammatory tissue alterations are not only elicited by bacterial, viral or other immunopathological processes but also by physically and chemically induced cellular damage, tissue ischemia and hypoxia. Regardless of whether one or more of these insults underlie SNHL, Ménière’s disease and NIHL, glucocorticoids effectively counteract subsequent inflammatory tissue damage in the auditory and vestibular system. This was confirmed in experimental studies on immune-mediated progressive SNHL, and thrombosis-induced and noise-induced cochlear ischemia, hypoxia and hearing loss. Glucocorticoid treatment results of immune-mediated progressive and acute idiopathic SNHL are promising, although placebo-controlled trials on the effect in acute idiopathic SNHL have revealed conflicting data (probably due to the small number of patients). Clinical studies on the effect of systemic glucocorticoid monotherapy on Ménière’s disease and NIHL have not yet been performed. After intratympanic application, relief of vertigo, tinnitus and preservation of hearing in Ménière’s disease was observed in previous studies; however, recently none of these effects have been confirmed in a placebo-controlled trial. Similarly, in contrast to previous reports, chronic tinnitus of various origins did not improve after repetitive glucocorticoid application onto the round window membrane using a micropump connected to an implanted microcatheter.

show abstract

“…ABRs did not recover until 8 weeks after application. Morphological intracochlear damage as assessed by light and transmission electron microscopy was not observed [150].…”

Section: Glucocorticoids Applied Locally Onto the Round Window Membranementioning

confidence: 86%

How Useful Is Corticosteroid Treatment in Cochlear Disorders?

Lamm¹,

Arnold²

1999

Otorhinolaryngol Nova

View full text Add to dashboard Cite

show abstract

“…In addition, not only the optimal dose of steroids, and the duration of treatment are largely unknown, and therefore often empirical, but also their limited ability to penetrate the blood-perilymph barrier may result in a suboptimal therapeutic effect (at least in non-toxic doses). By contrast, the intra-tympanic route of administration can provide organ-specific treatment, with two theoretical advantages; the potential of direct steroid uptake through the round window membrane, resulting in higher perilymph levels [74][75][76], and a lesser or none systemic steroid absorption and toxicity.…”

Section: Discussionmentioning

confidence: 99%

Are intra-tympanically administered steroids effective in patients with sudden deafness? Implications for current clinical practice

Vlastarakos

Papacharalampous

Maragoudakis³

et al. 2011

Eur Arch Otorhinolaryngol

View full text Add to dashboard Cite

Over 60 years since its first report, sudden sensorineural hearing loss (SSNHL) still represents an ill-explained condition, with potentially devastating effects for the quality of life of previously well patients. The present study critically reviewed the available evidence regarding the efficacy of intra-tympanic steroid administration in the treatment of SSNHL. Factors affecting that efficacy were also explored. The literature was systematically reviewed in Medline and other database sources until July 2011, and analyzed through critical analysis of pooled data. The study selection included multi-center prospective randomized control trials, prospective randomized comparative, prospective comparative and prospective studies, retrospective comparative and retrospective studies. The total number of analyzed studies was 43. Intra-tympanic steroids appear to be effective as primary (strength of recommendation A), or salvage treatment (strength of recommendation B) in SSNHL. It is difficult to draw definite conclusions regarding the efficacy of combination therapy. The identification of a time window for effective treatment in the former two approaches yields a grade C strength of recommendation. Primary intra-tympanic treatment is the most effective modality in terms of complete hearing recovery (34.4% cure rate). There is not enough evidence to attribute treatment failures to impaired permeability of the round window membrane. Most complications of intra-tympanic treatment are minor, temporary, and conservatively managed. Intra-tympanic steroids can theoretically provide a more organ-specific treatment in patients with SSNHL. The observation that they seem effective both as primary and salvage treatment modalities with a very low complication rate may have serious implications for current clinical practice.

show abstract

“…Our technique of penetrating the tympanic membrane docs not affect the ABR thresholds [13]. The animals served as their own controls, i.e.…”

Section: Methodsmentioning

confidence: 99%

“…The details of the ABR technique, a new frequency-specific nar row gating (± 100 Hz) technique, are described in detail in a separate article, including the procedure for calculating ABR-bascd frequency tuning curves [13,14],…”

Section: Methodsmentioning

confidence: 99%

Alpha-Bungarotoxin Inhibits Outer Hair Cell Motility in situ

Anniko

Stenqvist²,

Pettersson³

et al. 1995

ORL

Self Cite

View full text Add to dashboard Cite

The effect of two substances (α-bungarotoxin, α-BGTX, a small protein, and the local anesthetic bupivacaine hydrochloride) with an assumed effect on outer hair cell (OHC) motility were analyzed after exposing the cochlea via the round window membrane. Electrophysiological measurements were performed with a very narrow frequency-specific gating ( ± 100 Hz) technique to determine auditory brainstem response (ABR) thresholds, including ABR-based frequency tuning curves. Exposure to α-BGTX gave a minor improvement in thresholds, interpreted as a facilitation of OHCs, i.e. releasing their efferent inhibitory control, whereas exposure to bupivacaine hydrochloride impaired ABR thresholds, possibly due to immobilization of OHC motility via the lateral cell membrane. Our results are consistent with the hypothesis that efferent influence on the cochlea may be linked with a modulation of the mechanical function of OHCs. We can now postulate that there is in vivo evidence that acetylcholine exerts its effect at the OHCs via an α-BGTX binding acetylcholine receptor.

show abstract

Hydrocortisone Applied into the Round Window Niche Causes Electrophysiological Dysfunction of the Inner Ear

Cited by 41 publications

References 16 publications

How Useful Is Corticosteroid Treatment in Cochlear Disorders?

How Useful Is Corticosteroid Treatment in Cochlear Disorders?

Are intra-tympanically administered steroids effective in patients with sudden deafness? Implications for current clinical practice

Alpha-Bungarotoxin Inhibits Outer Hair Cell Motility in situ

Contact Info

Product

Resources

About