Marais J, Rutka J A
Otolaryngology Unit, University of Edinburgh, Royal Infirmary, UK.
Clin Otolaryngol Allied Sci. 1998 Aug;23(4):360-7. doi: 10.1046/j.1365-2273.1998.00161.x.
Topical aminoglycoside ear drops are theoretically acknowledged to be potentially ototoxic when administered in the presence of a tympanic membrane perforation. Although the development of clinical ototoxicity appears to be rare, nine well-documented and incontrovertible cases (12 ears in total) of iatrogenic topical vestibulotoxicity are presented, representing the largest series in the English language world literature to date. All patients were treated with the topical gentamicin-containing ear drops Garasone, (betamethasone sodium phosphate and gentamicin sulphate) for prolonged periods. Toxicity was found to be primarily vestibular rather than cochlear. Further review of five previously reported cases in addition to the findings from another four patients identified with topical ototoxicity are described. Although compensation occurred in unilateral cases the disability in bilateral cases was typically severe and often resulted in litigation.
理论上认为，在鼓膜穿孔的情况下使用局部用氨基糖苷类耳滴剂可能具有潜在耳毒性。虽然临床耳毒性的发生似乎很少见，但本文报告了9例记录良好且无可争议的医源性局部前庭毒性病例（共12耳），是迄今为止英语世界文献中最大的病例系列。所有患者均长期使用含庆大霉素的局部耳滴剂Garasone（倍他米松磷酸钠和硫酸庆大霉素）进行治疗。发现毒性主要影响前庭而非耳蜗。除了另外4例确诊为局部耳毒性的患者的研究结果外，还对之前报告的5例病例进行了进一步回顾。虽然单侧病例会出现代偿，但双侧病例的残疾通常很严重，且常常引发诉讼。
