King E B, Shepherd R K, Brown D J, Fallon J B
Bionics Institute of Australia, 384-388 Albert Street, East Melbourne, VIC, 3002, Australia.
Medical Bionics Department, University of Melbourne, Melbourne, VIC, Australia.
J Assoc Res Otolaryngol. 2017 Apr;18(2):291-299. doi: 10.1007/s10162-016-0609-1. Epub 2017 Jan 3.
Intratympanic gentamicin therapy is widely used clinically to treat the debilitating symptoms of Ménière's disease. Cochleotoxicity is an undesirable potential side effect of the treatment and the risk of hearing loss increases proportionately with gentamicin concentration in the cochlea. It has recently been shown that gentamicin is readily absorbed through the oval window in guinea pigs. The present study uses quantitative functional measures of vestibular and cochlea function to investigate the efficacy of treating the vestibule by applying a small volume of gentamicin onto the stapes footplate in guinea pigs. Vestibular and cochlea function were assessed by recording short latency vestibular evoked potentials in response to linear head acceleration and changes in hearing threshold, respectively, 1 and 2 weeks following treatment. Histopathology was analyzed in the crista ampullaris of the posterior semi-circular canal and utricular macula in the vestibule, and in the basal and second turns of the cochlea. In animals receiving gentamicin on the stapes footplate, vestibular responses were significantly suppressed by 72.7 % 2 weeks after treatment with no significant loss of hearing. This suggests that the vestibule can be treated directly by applying gentamicin onto the stapes footplate.
鼓室内庆大霉素疗法在临床上被广泛用于治疗梅尼埃病的致残症状。耳毒性是该治疗方法一种不良的潜在副作用，且听力损失风险与庆大霉素在耳蜗中的浓度成比例增加。最近有研究表明，庆大霉素在豚鼠中可通过卵圆窗被轻易吸收。本研究采用前庭和耳蜗功能的定量功能指标，通过在豚鼠镫骨足板上施加少量庆大霉素来研究治疗前庭的效果。在治疗后1周和2周，分别通过记录对线性头部加速度的短潜伏期前庭诱发电位和听力阈值变化来评估前庭和耳蜗功能。对后半规管壶腹嵴、前庭椭圆囊斑以及耳蜗底转和第二转进行组织病理学分析。在镫骨足板上接受庆大霉素治疗的动物中，治疗2周后前庭反应显著抑制了72.7%，听力无明显损失。这表明通过在镫骨足板上施加庆大霉素可直接治疗前庭。
