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.
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
This is a preview of subscription content, log in to check access.
I want to thank Professor Ilmari Pyykkö for his positive comments on the chapter and providing the image of Fig. 9.4. The writing was supported by the 7th Framework Programme project of the European Union, NANOCI (NMP4-SL-2012-281056).
Byl FM Jr (1984) Sudden hearing loss: eight years’ experience and suggested prognostic table. Laryngoscope 94(5 Pt 1):647–661PubMedGoogle Scholar
Havia M, Kentala E, Pyykko I (2005) Prevalence of Meniere’s disease in general population of Southern Finland. Otolaryngol Head Neck Surg 133(5):762–768PubMedCrossRefGoogle Scholar
Chen G et al (2012) A large-scale newborn hearing screening in rural areas in China. Int J Pediatr Otorhinolaryngol 76(12):1771–1774PubMedCrossRefGoogle Scholar
Zhang Z et al (2012) Auditory screening concurrent deafness predisposing genes screening in 10,043 neonates in Gansu province, China. Int J Pediatr Otorhinolaryngol 76(7):984–988PubMedCrossRefGoogle Scholar
Wang QJ et al (2011) Newborn hearing concurrent gene screening can improve care for hearing loss: a study on 14,913 Chinese newborns. Int J Pediatr Otorhinolaryngol 75(4):535–542PubMedCrossRefGoogle Scholar
Rauch SD et al (2011) Oral vs intratympanic corticosteroid therapy for idiopathic sudden sensorineural hearing loss: a randomized trial. JAMA 305(20):2071–2079PubMedCrossRefGoogle Scholar
Paasche G et al (2003) Technical report: modification of a cochlear implant electrode for drug delivery to the inner ear. Otol Neurotol 24(2):222–227PubMedCrossRefGoogle Scholar
Zou J et al (2008) Biocompatibility of different biopolymers after being implanted into the rat cochlea. Otol Neurotol 29(5):714–719PubMedCrossRefGoogle Scholar
Weber L (1879) On intratympanic injections in catarrhal affections of the middle ear. Br Med J 2(975):364–365CrossRefGoogle Scholar
Zhang Y et al (2011) Comparison of the distribution pattern of PEG-b-PCL polymersomes delivered into the rat inner ear via different methods. Acta Otolaryngol 131(12):1249–1256PubMedCrossRefGoogle Scholar
She W et al (2010) Hearing evaluation of intratympanic methylprednisolone perfusion for refractory sudden sensorineural hearing loss. Otolaryngol Head Neck Surg 142(2):266–271PubMedCrossRefGoogle Scholar
Yamazaki T, Hayashi M, Hayashi N, Kozaki H (1988) Intratympanic gentamicin therapy for Meniere’s disease placed by tubal catheter with systemic isosorbide. Arch Otorhinolaryngol 245(3):170–174PubMedCrossRefGoogle Scholar
Liu F, Huang WN, Song HT, Zhang QY (2008) Endolymphatic visualization in patients with Meniere’s disease. Zhongguo Yi Xue Ke Xue Yuan Xue Bao 30(6):651–654PubMedGoogle Scholar
Zhang Q et al (2012) Noninvasive intratympanic dexamethasone treatment for sudden sensorineural hearing loss. Acta Otolaryngol 132(6):583–589PubMedCrossRefGoogle Scholar
Silverstein H (1999) Use of a new device, the MicroWick, to deliver medication to the inner ear. Ear Nose Throat J 78(8):595–598, 600PubMedGoogle Scholar
Arriaga MA, Goldman S (1998) Hearing results of intratympanic steroid treatment of endolymphatic hydrops. Laryngoscope 108(11 Pt 1):1682–1685PubMedCrossRefGoogle Scholar
Husmann KR, Morgan AS, Girod DA, Durham D (1998) Round window administration of gentamicin: a new method for the study of ototoxicity of cochlear hair cells. Hear Res 125(1–2):109–119PubMedCrossRefGoogle Scholar
Zou J et al (2008) Distribution of lipid nanocapsules in different cochlear cell populations after round window membrane permeation. J Biomed Mater Res B Appl Biomater 87(1):10–18PubMedCrossRefGoogle Scholar
Zhang Y et al (2011) Inner ear biocompatibility of lipid nanocapsules after round window membrane application. Int J Pharm 404(1–2):211–219PubMedCrossRefGoogle Scholar
Zou J, Poe D, Ramadan UA, Pyykko I (2012) Oval window transport of Gd-dOTA from rat middle ear to vestibulum and scala vestibuli visualized by in vivo magnetic resonance imaging. Ann Otol Rhinol Laryngol 121(2):119–128PubMedGoogle Scholar
Ohashi M et al (2008) Histochemical localization of the extracellular matrix components in the annular ligament of rat stapediovestibular joint with special reference to fibrillin, 36-kDa microfibril-associated glycoprotein (MAGP-36), and hyaluronic acid. Med Mol Morphol 41(1):28–33PubMedCrossRefGoogle Scholar
Zou J, Yoshida T, Ramadan UA, Pyykko I (2011) Dynamic enhancement of the rat inner ear after ultra-small-volume administration of Gd-DOTA to the medial wall of the middle ear cavity. ORL J Otorhinolaryngol Relat Spec 73(5):275–281PubMedCrossRefGoogle Scholar
Carvalho GJ, Lalwani AK (1999) The effect of cochleostomy and intracochlear infusion on auditory brain stem response threshold in the guinea pig. Am J Otol 20(1):87–90PubMedGoogle Scholar
Pyykkö I (2010) Nanoear: 3g-Nanotechnology based targeted drug delivery using the inner ear as a model target organ. (Nanoear Project), pp An Integrated Project funded by the European Commission under the “nanotechnologies and nano-sciences, knowledge-based multifunctional materials and new production processes and devices” (NMP) thematic priority of the sixth framework programmeGoogle Scholar
Senn P (2012) NANOCI: nanotechnology based cochlear implants. (NANOCI), p The NANOCI Project is funded under the 7th framework programme of the European UnionGoogle Scholar