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[耳毒性的当前研究进展:局部耳毒性效应、诊断、预防及治疗]

[Current aspects of ototoxicity : Local ototoxic effects, diagnosis, prevention, and treatment].

作者信息

Walther L E, Hülse R, Lauer K, Wenzel A

机构信息

HNO-Gemeinschaftspraxis, Main-Taunus-Zentrum, 65843, Sulzbach (Taunus), Deutschland,

出版信息

HNO. 2015 May;63(5):383-92. doi: 10.1007/s00106-014-2981-7.

Abstract

The otorhinolaryngologist is often involved in an interdisciplinary approach to diagnose ototoxic side effects. Under certain conditions, chemical agents-particularly drugs-can have ototoxic effects. This is not only true for systemic administration, but also for local application (e.g., transdermal and transtympanal). Identifying and avoiding ototoxicity is still a challenge in clinical practice. The audiological monitoring of patients receiving potentially cochleotoxic drugs is now standardized. For diagnosis of suspected vestibulotoxic effects, the video head impulse test and vestibular evoked myogenic potentials seem to be suitable procedures for objective assessment. The early detection of such ototoxic effects has important implications for the prevention of hearing and balance disorders. Recent studies show that intratympanic delivery of medications might play an important role in the limitation of ototoxically induced hearing loss. In peripheral vestibulopathies with episodic vertigo, which strongly affect quality of life, ototoxic effects can be used for therapeutic purposes.

摘要

耳鼻喉科医生经常采用跨学科方法来诊断耳毒性副作用。在某些情况下,化学制剂——尤其是药物——可能会产生耳毒性作用。这不仅适用于全身给药,也适用于局部应用(如经皮和经鼓膜给药)。在临床实践中,识别和避免耳毒性仍然是一项挑战。目前,对接受潜在耳毒性药物治疗的患者进行听力学监测已实现标准化。对于疑似前庭毒性作用的诊断,视频头脉冲试验和前庭诱发肌源性电位似乎是客观评估的合适方法。早期发现此类耳毒性作用对预防听力和平衡障碍具有重要意义。最近的研究表明,鼓膜内给药可能在限制耳毒性所致听力损失方面发挥重要作用。在严重影响生活质量的发作性眩晕的外周前庭病变中,耳毒性作用可用于治疗目的。

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