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Systemic absorption of topical gentamicin sinus irrigation
Kevin K Wong1, Osama Marglani, Brian D Westerberg
1Division of Otolaryngology, Department of Surgery, University of British Columbia, Vancouver, British Columbia.
Summary
Systemic absorption of gentamicin during sinus surgery irrigation is possible but serum levels remain low. No significant hearing loss was observed, but further research is needed to confirm the safety of this topical sinus irrigation method.
Area of Science:
- Otolaryngology
- Pharmacology
- Nephrology
Background:
- Systemic absorption of gentamicin during intraoperative paranasal sinus irrigation is not well-documented.
- The potential for ototoxicity and retrograde migration to the middle ear requires investigation.
Purpose of the Study:
- To determine if topical gentamicin is absorbed systemically from the paranasal sinuses.
- To assess for hearing loss following topical gentamicin administration.
- To investigate the retrograde travel of gentamicin to the middle ear.
Main Methods:
- Prospective case series at a tertiary center.
- Intraoperative sinus cavity irrigation with fluorescein-stained gentamicin.
- Postoperative otoscopy and audiometry (pure-tone average and 8 kHz threshold).
Main Results:
- Twenty patients were enrolled; three had detectable serum gentamicin levels.
- Serum gentamicin levels were below therapeutic thresholds.
- Fluorescein was not visualized in the middle ear, and no significant hearing loss occurred.
Conclusions:
- Gentamicin can be absorbed from nasal mucosa during sinus irrigation, but systemic levels are low.
- The clinical significance of this absorption and the safety of topical sinus gentamicin irrigation warrant further study.
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