Preclinical and clinical studies of unrelieved aural fullness following intratympanic gentamicin injection in patients with intractable Ménière's disease.
Preclinical and clinical studies of unrelieved aural fullness following intratympanic gentamicin injection in patients with intractable Ménière's disease.
复制标题
DOI：
10.1159/000351805
复制
发表时间：
2013
影响因子：
1.6
通讯作者：
Dai CF
中科院分区：
文献类型：
--
作者：
Zhai F;Zhang R;Zhang T;Steyger PS;Dai CF
旨在阐明庆大霉素是否会影响豚鼠的前庭暗细胞并缓解鼓室内给药后患有顽固性梅尼埃病的患者的耳部饱满感。将纯化的庆大霉素-德克萨斯红 (GTTR) 注射到豚鼠鼓室内，并在第 1、3、7、14 和 28 天处死豚鼠。检查毛细胞中 GTTR 的摄取，检查前庭终末器官中的移行细胞和暗细胞。在鼓室内注射后，特别注意共聚焦显微镜下其在暗细胞中的分布，以及使用电子显微镜观察暗细胞的超微结构。鼓室内注射后第1、3、7、14和28天半规管暗细胞对GTTR的摄取较弱，注射后各时间点无显着差异。然而，邻近的移行细胞表现出强烈的 GTTR 摄取，并保留至少 28 天。超微结构研究表明，这些暗细胞中与细胞凋亡或坏死相关的特征可以忽略不计。注射后 7 或 28 天，暗细胞之间的紧密连接没有显示出破坏的迹象。鼓室内庆大霉素对前庭暗细胞几乎没有直接影响。对 29 名顽固性眩晕患者采用了改良的低剂量滴定鼓室内方法，并对临床结果进行了随访。根据我们的主观量表，鼓室内注射庆大霉素后的耳部饱满度并未得到缓解，注射前（4.16±3.08）和注射后（3.58±2.93；p>0.05）耳部饱满度评分之间没有统计学显着差异。 88% 的患者眩晕得到控制，16% 的患者听力下降。鼓室内注射庆大霉素可能不会缓解顽固性眩晕患者的耳闷感，尽管它可以达到较高的眩晕控制率并具有一定的耳蜗毒性。
To clarify whether gentamicin affects vestibular dark cells in guinea pigs and relieves patients of aural fullness with intractable Ménière’s disease following intratympanic administration. Purified gentamicin-Texas Red (GTTR) was injected intratympanically in guinea pigs that were sacrificed at 1, 3, 7, 14 and 28 days. GTTR uptake was examined in hair cells, and transitional cells and dark cells in vestibular end-organs were examined. Specific attention was paid to its distribution in dark cells under confocal microscopy, and the ultrastructure of dark cells using electron microscopy, following intratympanic injection. Dark cells in the semicircular canals showed weak GTTR uptake at 1, 3, 7, 14 and 28 days after intratympanic injection, with no significant differences at various time points after injection. However, the adjacent transitional cells demonstrated intense GTTR uptake that was retained for at least 28 days. Ultrastructural studies demonstrated negligible characteristics associated with apoptosis or necrosis in these dark cells. The tight junctions between dark cells showed no signs of disruption at 7 or 28 days after injection. Intratympanic gentamicin has little direct impact on vestibular dark cells. A modified low-dose titration intratympanic approach was used in 29 patients with intractable vertigo and the clinical outcomes were followed. Aural fullness following intratympanic gentamicin injection was not relieved based on our subjective scales, demonstrated by no statistically significant difference between preinjection (4.16 ± 3.08) and postinjection (3.58 ± 2.93; p > 0.05) aural fullness scores. Vertigo control was achieved in 88% of patients, with hearing deterioration identified in 16% of patients. Intratympanic gentamicin administration might not lead to relief of aural fullness in patients with intractable vertigo, although it can achieve a high vertigo control rate with some cochleotoxicity.
登录
查看更多内容
影响因子：
2.1
作者：
Fiorino, Francesco;Pizzini, Francesca B.;Barbieri, Franco
通讯作者：
Barbieri, Franco
影响因子：
1.4
作者：
CAMPBELL, KCM;HARKER, LA;ABBAS, PJ
通讯作者：
ABBAS, PJ
影响因子：
2.8
作者：
Pitovski, DZ;Kerr, TP
通讯作者：
Kerr, TP
影响因子：
1.4
作者：
Sass, K
通讯作者：
Sass, K
影响因子：
--
作者：
Devaiah, AK;Dawson, KL;Ator, GA
通讯作者：
Ator, GA