Kimura R S, Lee K S, Nye C L, Trehey J A
Department of Otolaryngology, Harvard Medical School, Boston.
Acta Otolaryngol. 1991;111(6):1021-30. doi: 10.3109/00016489109100751.
Streptomycin was injected subcutaneously into guinea pigs (n = 12) with unilateral endolymphatic hydrops. In the unoperated ears, sensory cells were degenerated at the basal ends of all cochleas and to varying extents in the vestibular sense organs. Hydropic ears, in contrast, showed greater ototoxicity in the cochlear and saccular sensory cells, while the drug's effect on the utricular and cristae sensory cells was increased, but less remarkable. In another series of normal animals (n = 16), streptomycin was applied to a fenestra of the lateral semicircular canal. Sensory cells of all three canal cristae and utricular macula were degenerated frequently, but the sensory cells of the cochleas were rarely affected. The vestibular lesions resulting from the canal approach were greater than those produced by systemic injection. Comparison with a former gentamicin-lateral canal series revealed very little difference in action of the two drugs. However, in hydropic ears, gentamicin application to the lateral canal produced increased lesions in all sensory cells, particularly in the organ of Corti. Hydropic ears are vulnerable and a greater caution is needed in administering aminoglycosides by both the systemic and the canal route to patients with Meniere's disease.
将链霉素皮下注射到患有单侧内淋巴积水的豚鼠(n = 12)体内。在未手术的耳朵中,所有耳蜗的基底端感觉细胞均发生退化,前庭感觉器官也有不同程度的退化。相比之下,积水耳的耳蜗和球囊感觉细胞表现出更大的耳毒性,而药物对椭圆囊和嵴感觉细胞的作用增强,但不太明显。在另一组正常动物(n = 16)中,将链霉素应用于外侧半规管的开窗处。所有三个半规管嵴和椭圆囊斑的感觉细胞经常发生退化,但耳蜗的感觉细胞很少受到影响。经半规管途径导致的前庭损伤大于全身注射所致的损伤。与之前的庆大霉素-外侧半规管系列比较发现,两种药物的作用差异很小。然而,在积水耳中,将庆大霉素应用于外侧半规管会使所有感觉细胞,尤其是柯蒂氏器的损伤增加。积水耳很脆弱,对于梅尼埃病患者,通过全身和半规管途径给予氨基糖苷类药物时需要格外谨慎。