INTRATYMPANIC THERAPIES FOR INNER EAR DISORDERS 

Otorinolaringologia 2010 September;60(3):183-8

Copyright © 2010 EDIZIONI MINERVA MEDICA

language: English

Intratympanic gentamicin: its effect on hearing and strategies to minimize inner ear damage

Citraro L., De Stefano A., Kulamarva G., Dispenza F., Croce A.

¹ ENT Istitute, Department of Surgical, Clinical and Experimental Sciences, “G. d’Annunzio” University of Chieti-Pescara Chieti, Italy 2 ENT Clinic, Nayak’s Road, Kasaragod, India 3 Department of Surgical and Oncological Disciplines University of Palermo, Palermo, Italy

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Intratympanic gentamicin injection is the easiest and least invasive treatment available for Menière’s disease as compared to other procedures available today. The most important side effect of this therapy however is sensorineural hearing loss primarily at the high frequencies. Ototoxicity of gentamicin begins at the outer hair cells of the basal turn of cochlea and progresses apically. It can even involve inner hair cells. Hair cell death from ototoxicity can be either necrotic or apoptotic. Many protocols have been developed to reduce gentamicin cochleotoxicity. Among these, low dose and long interval of injections (hybrid) protocols showed the best results with good rates of vertigo control and low rates of hearing loss. Animal experiments have shown many drugs such as iron chelators, antioxidants, and glucocorticoids to be having otoprotective properties. But more research is needed to find reliable otoprotective strategies using these agents. Genetic studies and gene therapy appears to be the new and promising frontier in treating this dreadful sequelae of treating MD.