The Effect of Nystatin Solution on Otoacoustic Emissions in Rats

Abstract

OBJECTIVE:In patients with a perforated tympanic membrane, topically administered medication reaches the middle ear and thus creates a risk of ototoxicity. The aim of the present study was to evaluate the possible ototoxic effect of the antifungal medication nystatin when administered to the rat middle ear cavity. MATERIALS and METHODS:Three groups (negative control, positive control, and study groups), each containing eight rats, were formed. Before the drug administration, distortion product otoacoustic emissions were recorded in both ears of each rat. Saline (0.09% NaCl), gentamycin, and nystatin solutions were transtympanically injected into the middle ear cavities of the negative control, positive control, and study groups, respectively, for five consecutive days. Seven days after the last infiltration, the control otoacoustic emission was measured, and the data of the 2, 3, 4, 6, 8 kHz frequencies were statistically analyzed. RESULTS:There were no significant changes between the 1 st and 2 nd measures in the negative control group (0.09% NaCl) (p>0.05), whereas there were significant changes between the 1 st and 2 nd measures in the positive control group (gentamycin) and study group (nystatin) (p<0.05). CONCLUSION:Ototopical medications carry a risk of ototoxicity in patients with perforated ear drums. In the present study, it was shown that nystatin, an antifungal that can be ototopically used in the treatment of otomycosis, may cause a decrease in otoacoustic emissions in rats when administered into the middle ear cavities.

Drug‐Induced Ototoxicity: A Comprehensive Review and Reference Guide

“…48 Nystatin does not have reported ototoxicity in clinical use, but animal data are controversial. 46,[49][50][51] None of the antifungal drugs studied in animal models caused vestibular toxicity except for gentian violet. 50 Gentian violet is an aniline dye that has antiinflammatory, antifungal, and antibacterial properties and seems to cause extensive cochlear and vestibular damage in animal experiments.…”

“…Of note, ketoconazole and itraconazole have been reported to cause tinnitus and hearing loss in less than 2% of cases 48 . Nystatin does not have reported ototoxicity in clinical use, but animal data are controversial 46, 49–51 . None of the antifungal drugs studied in animal models caused vestibular toxicity except for gentian violet 50 .…”