Principles of local drug delivery to the inner ear

Alec N. Salt, Stefan K. Plontke

Research output: Contribution to journalReview articlepeer-review

178 Scopus citations

Abstract

As more and more substances have been shown in preclinical studies to be capable of preventing damage to the inner ear from exposure to noise, ototoxic drugs, ischemia, infection, inflammation, mechanical trauma and other insults, it is becoming very important to develop feasible and safe methods for the targeted delivery of drugs to specific regions in the inner ear. Recently developed methods for sampling perilymph from the cochlea have overcome major technical problems that have distorted previous pharmacokinetic studies of the ear. These measurements show that drug distribution in perilymph is dominated by passive diffusion, resulting in large gradients along the cochlea when drugs are applied intratympanically. Therefore, in order to direct drugs to specific regions of the ear, a variety of delivery strategies are required. To target drugs to the basal cochlear turn and vestibular system while minimizing exposure of the apical cochlear turns, single one-shot intratympanic applications are effective. To increase the amount of drug reaching the apical cochlear turns, repeated intratympanic injections or controlled-release drug delivery systems, such as biodegradable biopolymers or catheters and pumps, are more effective. However, if the applied substance does not easily pass through the round window membrane, or if a more widespread distribution of drug in the ear is required, then intralabyrinthine injections of the substance may be required. Intralabyrinthine injection procedures, which are currently in development in animals, have not yet been proven safe enough for human use.

Original languageEnglish
Pages (from-to)350-360
Number of pages11
JournalAudiology and Neurotology
Volume14
Issue number6
DOIs
StatePublished - Nov 2009

Keywords

  • Animal
  • Cochlea
  • Controlled release
  • Human
  • Inner ear
  • Local drug delivery
  • Perilymph
  • Pharmacokinetics

Fingerprint

Dive into the research topics of 'Principles of local drug delivery to the inner ear'. Together they form a unique fingerprint.

Cite this