title: Vestibular destruction by slow infusion of gentamicin into semicircular canals.
abstract: Intratympanic or round window application of gentamicin is often used to alleviate disabling vertigo arising from unilateral Meniere's disease; however, treatment is often accompanied by hearing loss because the drug initially enters the cochlea before diffusing to the vestibular system. In order to enhance vestibular damage and reduce the risk of hearing loss, gentamicin was infused directly into the vestibular system. An osmotic pump containing 50, 100, 200 or 400 microg/ml of gentamicin was infused into the superior semicircular canal of the chinchilla for 7 days. Afterwards, vestibular damage was evaluated by measuring the decline in hair cell density in the utricle, saccule and superior semicircular canals. Auditory damage was assessed with distortion product otoacoustic emissions (DPOAE) and outer hair cell (OHC) and inner hair cell (IHC) loss. Infusion with the two lowest gentamicin concentrations resulted in significant hair cell loss and reduced duration of the nystagmus response, but had little or no effect on OHC or DPOAE. Higher doses of gentamicin damaged cochlear hair cells and reduced the DPOAE. In conclusion, slow infusion of a low dose of gentamicin into the semicircular canals mainly damages the vestibular hair cells and inactivates the nystagmus response without damaging cochlear hair cells or DPOAE.
authors.affiliation: Department of Otolaryngology, Yueyang Hospital of Shanghai Traditional Medical and Pharmacy University, Shanghai, China.
authors.forename: Ming
authors.initials: M
authors.lastname: Lii
authors.forename: Dalian
authors.initials: D
authors.lastname: Ding
authors.forename: Xiang-Yang
authors.initials: XY
authors.lastname: Zheng
authors.forename: Richard
authors.initials: R
authors.lastname: Salvi
mesh_terms: D000818:Animals; D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000009:adverse effects*; D002682:Chinchilla; D004305:Dose-Response Relationship, Drug; D005839:Gentamicins / Q000008:administration & dosage* / Q000009:adverse effects*; D006198:Hair Cells, Auditory / Q000187:drug effects; D034381:Hearing Loss / Q000517:prevention & control; D015918:Infusion Pumps, Implantable; D008575:Meniere Disease / Q000188:drug therapy*; D009760:Nystagmus, Physiologic / Q000187:drug effects; D017084:Otoacoustic Emissions, Spontaneous / Q000187:drug effects; D012665:Semicircular Canals / Q000187:drug effects*; D014722:Vestibule, Labyrinth / Q000187:drug effects / Q000503:physiopathology
chemical_list: D000900:Anti-Bacterial Agents; D005839:Gentamicins