Chandrasekhar S S, Rubinstein R Y, Kwartler J A, Gatz M, Connelly P E, Huang E, Baredes S
Division of Otolaryngology-Head and Neck Surgery, University of Medicine and Dentistry of New Jersey, New Jersey Medical School, Newark, NJ 07103-2714, USA.
Otolaryngol Head Neck Surg. 2000 Apr;122(4):521-8. doi: 10.1067/mhn.2000.102578.
There is growing otologic interest in treating inner ear disorders, such as sudden sensorineural hearing loss and acute or unremitting Meniere's disease, with intratympanic dexamethasone (IT-DEX). Although anecdotally reported, there are no scientific clinical papers and few prior laboratory research publications on the subject. This study compares perilymph dexamethasone concentrations after systemic and intratympanic administration and assesses the role of 3 potential transport facilitators of IT-DEX into perilymph. Forty guinea pigs (79 ears) were randomly separated into 5 groups. Dexamethasone levels were measured by radioimmunoassay. IT-DEX resulted in higher perilymph steroid levels than intravenous dexamethasone (P < 0.05). Histamine facilitator resulted in significantly higher perilymph steroid levels than IT-DEX alone (P < 0.05). Neither hyaluronic acid nor dimethylsulfoxide was a potent facilitator. This study demonstrates that IT-DEX administration results in superior perilymph levels within 1 hour of administration and does not result in systemic absorption. Histamine is a potent facilitating agent. The clinical implications are considerable.
对于采用鼓室内地塞米松（IT-DEX）治疗内耳疾病，如突发性感音神经性听力损失和急性或持续性梅尼埃病，耳科学领域的关注度日益增加。尽管有一些轶事报道，但关于该主题尚无科学的临床论文，先前的实验室研究出版物也很少。本研究比较了全身给药和鼓室内给药后外淋巴液中的地塞米松浓度，并评估了IT-DEX进入外淋巴液的3种潜在转运促进剂的作用。40只豚鼠（79只耳朵）被随机分为5组。通过放射免疫分析法测量地塞米松水平。与静脉注射地塞米松相比，IT-DEX导致外淋巴液中类固醇水平更高（P < 0.05）。组胺促进剂导致外淋巴液中类固醇水平显著高于单独使用IT-DEX（P < 0.05）。透明质酸和二甲亚砜都不是有效的促进剂。本研究表明，IT-DEX给药后1小时内可使外淋巴液水平升高，且不会导致全身吸收。组胺是一种有效的促进剂。其临床意义重大。
