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Intratympanic ciprofloxacin and the human labyrinthine sampling model
Zoran Becvarovski1, Jack M Kartush, Dennis I Bojrab
1Michigan Ear Institute, Farmington Hills, USA. zb@ent.com.au
Objective:
The aim of the study was to investigate the potential absorption of intratympanic ciprofloxacin through the human round window membrane.
Study Design:
A prospective study.
Methods:
Ciprofloxacin was instilled into the middle ear of 10 patients undergoing acoustic tumor removal. The lateral semicircular canal and vestibule were subsequently opened and, using a microsyringe, labyrinthine fluid was aspirated. A sample each of serum and cerebrospinal fluid was also drawn.
Results:
Into each middle ear, 0.5 mL ciprofloxacin (0.3%) was instilled. The time interval between the ciprofloxacin application to the round window membrane and sampling of labyrinthine fluid and plasma ranged from 9 to 120 minutes. There was no measurable ciprofloxacin in the labyrinthine fluid, cerebrospinal fluid, or serum of 10 patients.
Conclusion:
The lack of measurable absorption of intratympanic ciprofloxacin into the inner ear indicates that the chance of ototoxicity when ciprofloxacin is used clinically, even in the presence of a tympanic membrane perforation, is low.