Filipo R, Barbara M, Cordier A, Mafera B, Romeo R, Attanasio G, Mancini P, Marzetti A
Department of Otolaryngology, University of Rome La Sapienza, Italy.
Acta Otolaryngol. 1997 Mar;117(2):229-31. doi: 10.3109/00016489709117777.
On the grounds of positive results obtained with Meniere's patients, agents such as glycerol and mannitol have been included in the therapeutical protocol of other cochlear disorders presenting with hearing loss either of sudden onset, but not observed at an early stage, or accompanied by tinnitus and aural pressure. Intravenous infusions of either 10% glycerol or 18% mannitol were given to selected patients 3 to 6 times with a time interval of 1 to 3 days. Hearing loss, tinnitus and aural pressure were evaluated as improved, unchanged or worsened. In 33% of the glycerol group and 23.8% of the mannitol group we observed hearing threshold improvement, while aural fullness improved in 45% of the glycerol and 56.2% of the mannitol groups, and tinnitus was only relieved in 13.1% of the glycerol and 5.8% of the mannitol group. A parallel experimental study was carried out on guinea-pigs in order to shed light on the effects of mannitol and glycerol on the inner ear. Cochlear blood flow was measured with a laser Doppler flowmeter at the level of the basal turn of the cochlear lateral wall, both in normal and hydropic guinea-pigs, before and after osmotic intraperitoneal infusion. Basal values in the normal cochlea were much higher than in the hydropic one, and both mannitol and glycerol markedly influenced the local blood flow in the normal cochlea, giving few or no changes in the hydropic one.
基于对梅尼埃病患者取得的积极效果，诸如甘油和甘露醇等药物已被纳入其他伴有听力损失的耳蜗疾病的治疗方案中，这些疾病要么起病突然但早期未被观察到，要么伴有耳鸣和耳内闷胀感。对选定患者静脉输注10%甘油或18%甘露醇，3至6次，时间间隔为1至3天。对听力损失、耳鸣和耳内闷胀感评估为改善、无变化或恶化。在甘油组中33%以及甘露醇组中23.8%的患者，我们观察到听力阈值改善，而耳胀满感在甘油组45%以及甘露醇组56.2%的患者中得到改善，耳鸣仅在甘油组13.1%以及甘露醇组5.8%的患者中得到缓解。为了阐明甘露醇和甘油对内耳的影响，在豚鼠身上进行了一项平行实验研究。在正常和积水豚鼠经腹膜渗透性输注前后，用激光多普勒血流仪在耳蜗外侧壁基底转水平测量耳蜗血流量。正常耳蜗的基础值远高于积水耳蜗，并且甘露醇和甘油均显著影响正常耳蜗的局部血流量，而积水耳蜗几乎没有变化或没有变化。
