Focal Drug Delivery in Inner Ear Therapy
Focal drug delivery in inner ear therapy such as intratympanic gentamicin sulphate injection for the treatment of Meniere’s disease and intratympanic corticosteroid therapy for idiopathic sudden sensorineural hearing loss has recently gained increasing popularity, partially because of its convenience, efficacy, and reduced systemic drug exposure and associated systemic adverse effects. This chapter describes the current scope of focal drug delivery in inner ear therapy including intratympanic perfusion (transtympanic injections using needles, transtympanic catheter injections, and trans-Eustachian tube catheter injections), organ-targeted delivery (round window diffusion-MicroWick device, round window diffusion-gelatine sponge, oval window diffusion-polyimide microlumen, tympanic medial wall diffusion), and direct cochlear drug delivery—the next-generation cochlear implant. The advantages and disadvantages of each technique are compared.
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