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Systemic absorption of gentamicin nasal irrigations
W Stites Whatley1, Rakesh K Chandra, C Bruce MacDonald
1Department of Otolaryngology-Head and Neck Surgery, University of Tennessee, 956 Court Avenue, Memphis, TN 38163, USA. wwhatley@midsouth.rr.com
American Journal of Rhinology
|July 29, 2006
Summary
Gentamicin nasal irrigation may be absorbed into the bloodstream, with detectable levels found in most patients. While significant hearing loss was not observed, potential ototoxic effects warrant patient counseling.
Area of Science:
- Otolaryngology
- Pharmacology
- Nephrology
Background:
- Chronic rhinosinusitis (CRS) often requires advanced treatment strategies.
- Gentamicin, an aminoglycoside antibiotic, is typically administered systemically for severe infections.
- The use of topical gentamicin via nasal irrigation for CRS is less understood regarding systemic absorption and ototoxicity.
Purpose of the Study:
- To investigate the systemic absorption of gentamicin following nasal irrigation.
- To evaluate potential ototoxic side effects associated with gentamicin nasal irrigation therapy.
Main Methods:
- A retrospective review of 12 patients with CRS who received gentamicin nasal irrigations.
- Serum gentamicin levels were measured post-treatment.
- Audiometry and distortion product otoacoustic emissions (DP-OAEs) were performed before and after therapy to assess hearing function.
Main Results:
- 83% of patients exhibited detectable post-treatment serum gentamicin levels (mean 0.42 mcg/mL).
- 33% of patients had serum levels within the typical therapeutic trough range.
- No significant changes in audiometry or DP-OAEs were noted, except for a minor hearing loss at 8000 Hz in one ear; no patients reported subjective hearing issues or vertigo.
Conclusions:
- Gentamicin nasal irrigation can lead to systemic absorption.
- The clinical significance of this absorption and potential ototoxicity remains uncertain.
- Patients undergoing gentamicin nasal irrigation should be informed about the theoretical risk of otologic side effects.
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Possible causes of this condition include high blood pressure, trauma, low humidity, upper respiratory tract infections, allergies, foreign bodies, nasal inhalation of corticosteroids or illicit drugs, excessive use of decongestant nasal sprays, facial or nasal surgery, anatomic malformation, tumors, or systemic...
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Possible causes of this condition include high blood pressure, trauma, low humidity, upper respiratory tract infections, allergies, foreign bodies, nasal inhalation of corticosteroids or illicit drugs, excessive use of decongestant nasal sprays, facial or nasal surgery, anatomic malformation, tumors, or systemic...