Chin Oliver Y, Diaz Rodney C
Department of Otolaryngology - Head and Neck Surgery, University of California, Davis Medical Center, Sacramento, California, USA.
Curr Opin Otolaryngol Head Neck Surg. 2019 Oct;27(5):381-386. doi: 10.1097/MOO.0000000000000566.
Increasing awareness and prevalence of disorders in hearing and balance have placed emphasis on treatment strategies. With the rapid evolution in molecular, gene, and nanotechnology, alternate delivery methods have advanced intracochlear drug delivery. This review aims to raise awareness of recent developments in technologies to augment current clinical practices.
Intracochlear drug delivery research has expanded with the familiarity and accessibility to cochlear implantation. Various therapeutics are closely studied for both safety and efficacy as well as biologic effect. Agents including neurotrophins, antiapoptotics, cell therapy, gene therapy, and anti-inflammatory drugs are on the forefront of preclinical research. Cochlear implant electrode modification and drug administration at the time of implantation is a major focus of research. Improvements in study design have focused on overcoming barriers including elucidating the role of the blood-perilymph barrier.
Inner ear drug delivery methods include systemic, intratympanic, and intracochlear administration. Therapeutic technologies aim to overcome delivery barriers and to improve overall biologic effect while minimizing toxicity. Precision of drug application through intratympanic and intracochlear administration with minimal trauma is the future of inner ear drug development.
听力和平衡障碍的认知度及患病率不断提高，这使得人们更加关注治疗策略。随着分子、基因和纳米技术的迅速发展，替代给药方法推动了耳蜗内药物递送的进步。本综述旨在提高人们对增强当前临床实践的技术最新进展的认识。
随着人工耳蜗植入技术的普及和应用，耳蜗内药物递送研究不断扩展。对各种治疗方法的安全性、有效性以及生物学效应进行了深入研究。神经营养因子、抗凋亡药物、细胞治疗、基因治疗和抗炎药物等制剂处于临床前研究的前沿。人工耳蜗电极改良及植入时给药是研究的重点。研究设计的改进集中在克服障碍，包括阐明血-外淋巴屏障的作用。
内耳药物递送方法包括全身给药、鼓室内给药和耳蜗内给药。治疗技术旨在克服递送障碍，提高整体生物学效应，同时将毒性降至最低。通过鼓室内和耳蜗内给药实现药物精准应用且创伤最小，这是内耳药物研发的未来方向。
