Daniel Sam Joseph, Sahmkow Sofia Isabel, Munguia Raymundo, Schloss Melvin, Akache Fadi
McGill University, Montreal, Quebec, Canada.
Laryngoscope. 2008 Mar;118(3):478-82. doi: 10.1097/MLG.0b013e31815d8e41.
The use of earwax softeners and cerumenolytics to unblock the external auditory canal is increasing. Although reports on their effectiveness are available, data about their effect on hearing are limited.
To assess the effect of ototopic triethanolamine polypeptide oleate condensate 10% (Cerumenex) on hearing.
Prospective, randomized, controlled trial in a chinchilla animal model.
Tympanostomy tubes were inserted in five chinchillas, and hearing was assessed with distortion product otoacoustic emissions (DPOAE) between 1 and 9 kHz prior to application and at days 1, 4, 30, and 100 postototopic application of Cerumenex. One ear received Cerumenex; the other ear served as control. Postmortem scanning electron microscopy was performed to assess the cochlear hair cells.
A reduction in the mean DPOAE signal was shown in the ears treated with Cerumenex from the first day after treatment and throughout the study. Almost all tested frequencies were affected. Swelling, crusting, and fluid were observed in four of the five experimental ears. One animal also developed facial paralysis in the experimental side. Electron microscopy showed damage of the outer and inner hair cells in the Cerumenex-treated ears.
In the chinchilla, when a tympanic perforation is present, Cerumenex causes a reduction in DPOAE signal and damage to the cochlear hair cells. Caution should be observed when prescribing this agent if the status of the tympanic membrane is unknown. Furthermore, its use without medical prescription should be discouraged because of the risk of ototoxicity and severe inflammatory reaction.
使用耳垢软化剂和耵聍溶解剂来疏通外耳道的情况日益增多。尽管有关于其有效性的报道,但关于它们对听力影响的数据有限。
评估10%的耳用三乙醇胺多肽油酸酯缩合物(Cerumenex)对听力的影响。
在龙猫动物模型中进行的前瞻性、随机、对照试验。
给5只龙猫插入鼓膜造口管,在应用Cerumenex之前以及应用后第1天、第4天、第30天和第100天,用畸变产物耳声发射(DPOAE)评估1至9千赫兹之间的听力。一只耳朵接受Cerumenex治疗;另一只耳朵作为对照。进行死后扫描电子显微镜检查以评估耳蜗毛细胞。
从治疗后的第一天起以及在整个研究过程中,接受Cerumenex治疗的耳朵中DPOAE平均信号降低。几乎所有测试频率都受到影响。在5只实验耳朵中的4只观察到肿胀、结痂和积液。一只动物在实验侧还出现了面瘫。电子显微镜显示,接受Cerumenex治疗的耳朵中外毛细胞和内毛细胞受损。
在龙猫中,当存在鼓膜穿孔时,Cerumenex会导致DPOAE信号降低并损害耳蜗毛细胞。如果鼓膜状态不明,在开这种药时应谨慎。此外,由于存在耳毒性和严重炎症反应的风险,不应鼓励无医疗处方使用该药。