Topical therapy for the treatment of inner ear deafness, tinnitus and vertigo

采用前瞻性随机双盲研究方法，评价60 mW激光照射治疗耳鸣的疗效。在耳鸣的响度、持续时间、质量和烦扰方面，主动激光组和安慰剂激光组之间没有显著差异。最近，有许多报道描述了庆大霉素鼓室内注射治疗梅尼埃病患者顽固性眩晕的疗效。用豚鼠测定外用庆大霉素后耳蜗底回外淋巴液中庆大霉素的浓度。大约1-2小时后，庆大霉素浓度达到最大值，然后下降，半衰期为2-数小时。前庭代偿预计在庆大霉素鼓室内治疗后进行。即使在临床上认为前庭对比完全后，垂直眼动振荡的频率也是…的两倍α-生育酚具有抑制顺铂耳毒性的作用。用激光多普勒和微球法观察了阻断小脑前下动脉(AICA)对大鼠耳蜗血流量的影响。我们推测，在大鼠耳蜗血流量完全中断期间，残留的激光多普勒输出基本上归因于耳蜗骨中的血液流动。因此，我们认为不应忽视耳蜗骨周围的血流。我们用激光多普勒探头对20例人工耳蜗术患者在耳蜗骨骨壁打开前、中、后进行了耳蜗血流量的测量。耳蜗血流量明显减少6例，其中特发性进行性感音神经性聋2例，原因不明先天性聋2例，内耳道狭窄1例，脑膜炎后聋1例。较少

Prospective, randomized double-blind study was performed to evaluate effectiveness of 60-mW laser irradiation in the treatment of tinnitus. No significant difference was observed between the active and placebo laser groups with regard to outcome of loudness, duration, quality, and annoyance of tinnitus.Recently, there have been many reports describing efficacy of intratympanic gentamicin injection for the treatment of intractable vertigo in patients with Meniere's disease. Using guinea pigs, we measured gentamicin concentration of perilymph in the basal turn of the cochlea after topical application of gentamicin to the round window. After about 1 or 2 hours, the gentamicin concentration reached a maximum level and then decreased, with a half-life of two or several hours.Vestibular compensation is expected after the intratympanic gentamicin therapy. Even after the vestibular compasation was considered complete clinically, vertical eye-movement oscillation with a frequency double that of … More lateral linear acceleration was observed.We suggested that α-tocopherol suppresses CDDP-induced ototoxicity. We also found that prostaglandin E1 put on the round window elevated cochlear blood flow in guinea pigs.The effects of anterior inferior cerebellar artery (AICA) occlusion on cochlear blood flow were investigated in rats using the laser-Doppler and microsphere methods. We inferred that during complete interruption of cochlear blood flow in rats, residual laser-Doppler output was essentially attributable to blood flow in the bone surrounding the cochlea. Accordingly, we considered that blood flow in the bone which surrounds the cochlea should not be neglected.We measured cochlear blood flow in 20 patients who received cochlear implants using a laser-Doppler probe before, during, and after the cochlear bony wall had been opened. There were six cases in which significant reduction of cochlear blood flow was recognized ; two patients with idiopathic progressive sensorineural hearing loss, two congenital deaf patients with unknown cause, one patient with narrow internal auditory canal, one postmeningitic deaf patient. Less