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Begrenzung chronischer Hörverluste durch lokale Glukokortikoidgabe

Meerschweinchen mit akutem Lärmtrauma

Reduction of permanent hearing loss by local glucocorticoid application

Guinea pigs with acute acoustic trauma. German version

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Zusammenfassung

Hintergrund

Die Lärmexposition bei Knall- oder Explosionsereignissen führt neben dem akuten Hörverlust häufig zu einem irreversiblen chronischen Hörverlust als Langzeitfolge. Im Projekt wurde anhand eines präklinischen Tiermodells des akuten Lärmtraumas ein Behandlungskonzept zur Begrenzung chronischer Folgeschäden entwickelt.

Ziel der Arbeit

Durch die Verwendung von Fertigarzneimitteln sollte die Basis für klinische Studien und eine Behandlung des akuten Lärmtraumas geschaffen werden. Das otoprotektive Potenzial von Glukokortikoiden bei lokaler Applikation an das Innenohr wurde untersucht.

Material und Methoden

Versuchsreihen mit Impulsschall wurden durchgeführt. Um permanente Hörverluste darzustellen, betrug die Überlebenszeit nach der Beschallung 14 Tage. Hör- und Haarzellerhalt wurde in Abhängigkeit von der Glukokortikoiddosierung untersucht.

Ergebnisse

Nach Impulsschall zeigte die lokale Applikation von hochdosiertem Prednisolon (25 mg/ml) oder Methylprednisolon (12,5 mg/ml) am runden Fenster der Cochlea eine statistisch signifikante Reduktion der Hörschwellenverluste im Vergleich zur Kontrollgruppe.

Schlussfolgerung

Eine Applikation des Wirkstoffs am runden Fenster der Cochlea zur Erzielung hoher Wirkstoffkonzentrationen erscheint notwendig für eine effektive Therapie des akuten Lärmtraumas.

Abstract

Background

High-intensity noise exposure from impulse and blast noise events often leads to acute hearing loss and may cause irreversible permanent hearing loss as a long-term consequence. Here, a treatment regime was developed to limit permanent damage based on a preclinical animal model of acute noise trauma.

Aim

To develop clinical trials for the treatment of acute noise traumas using approved drugs. The otoprotective potential of glucocorticoids applied locally to the inner ear was examined.

Materials and methods

A series of experiments with different impulse noise exposures was performed. Permanent hearing loss and hair cell density were assessed 14 days after exposure. Hearing and hair cell preservation were investigated as a function of glucocorticoid dose.

Results

After impulse noise exposure, local application of high-dose prednisolone (25 mg/ml) or methylprednisolone (12.5 mg/ml) to the round window of the cochlea resulted in a statistically significant reduction in hearing loss compared to the control group.

Conclusion

Local application of high doses of the drugs to the round window of the cochlea appears to be an effective treatment for acute noise trauma.

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Förderung

Gefördert durch Mittel des BMVg M/SAB1/5/A014.

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Authors and Affiliations

  1. Universitätsklinik für Hals-Nasen-Ohren-Heilkunde, Medizinischer Campus Universität Oldenburg, Oldenburg, Deutschland

    M. Müller & H. Löwenheim

  2. Universitäts-Hals-Nasen-Ohren-Klinik, Universität Tübingen, Elfriede-Aulhorn-Str. 5, 72076, Tübingen, Deutschland

    M. Müller

  3. Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Bundeswehrkrankenhaus Ulm, Ulm, Deutschland

    M. Tisch & H. Maier

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  1. M. Müller
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Correspondence to M. Müller.

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Interessenkonflikt

M. Müller, M. Tisch, H. Maier und H. Löwenheim geben an, dass kein Interessenkonflikt besteht.

Alle nationalen Richtlinien zur Haltung und zum Umgang mit Labortieren wurden eingehalten und die notwendigen Zustimmungen der zuständigen Behörden (Regierungspräsidium Tübingen) lagen vor.

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Die englische Version dieses Beitrags ist unter doi: 10.1007/s00106-016-0266-z zu finden.

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Müller, M., Tisch, M., Maier, H. et al. Begrenzung chronischer Hörverluste durch lokale Glukokortikoidgabe. HNO 64, 831–840 (2016). https://doi.org/10.1007/s00106-016-0256-1

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