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Vestibular and cochlear toxicity of aminoglycosides--a review
T Nakashima1, M Teranishi, T Hibi
1Department of Otorhinolaryngology, Nagoya University School of Medicine, Japan. tsutomun@tsuru.med.nagoya-u.ac.jp
Abstract:
Recently, there have been many reports describing the efficacy of intratympanic aminoglycoside injection for the treatment of intractable vertigo in patients with Ménière's disease. However, the number of injections and the amount of drug injected varies, with concomitant variation in the side-effect of hearing deterioration. To identify drugs that are more selectively vestibulotoxic, we have reviewed the ototoxicity of aminoglycosides, focusing on differences between vestibulo- and cochleotoxicity. At present, the basis for the different effects of each drug is unknown. The mechanisms of vestibulo- and cochleotoxicity are deemed worthy of further study.
Insights
Intratympanic aminoglycoside injections effectively treat Ménière
Area of Science:
- Otolaryngology and Pharmacology
- Neuroscience and Vestibular System Research
Background:
- Intratympanic aminoglycoside injections are increasingly reported for intractable vertigo in Ménière's disease.
- Variability in injection protocols and dosages correlates with hearing loss side effects.
- A need exists to differentiate aminoglycosides based on selective vestibulotoxicity versus cochleotoxicity.
Purpose of the Study:
- To review the ototoxicity of aminoglycosides, specifically comparing vestibulotoxicity and cochleotoxicity.
- To identify aminoglycoside drugs with greater selectivity for vestibular damage over auditory damage.
Main Methods:
- Literature review of ototoxicity studies concerning aminoglycosides.
- Analysis focused on differentiating between vestibular and cochlear adverse effects.
- Comparison of reported effects across different aminoglycoside compounds.
Main Results:
- Aminoglycosides exhibit varying degrees of ototoxicity.
- Current data does not elucidate the basis for differential vestibulotoxicity and cochleotoxicity among these drugs.
- The precise mechanisms underlying selective vestibulo- versus cochleotoxicity remain undetermined.
Conclusions:
- Further research into the mechanisms of aminoglycoside ototoxicity is crucial.
- Understanding these mechanisms may lead to the development of more targeted treatments for Ménière's disease.
- Identifying selectively vestibulotoxic drugs could minimize hearing deterioration in vertigo treatment.