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Ototoxicity and topical eardrops

J Marais1, J A Rutka

  • 1Otolaryngology Unit, University of Edinburgh, Royal Infirmary, UK.

Clinical Otolaryngology and Allied Sciences
|October 8, 1998
PubMed
Summary
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Topical aminoglycoside ear drops, like Garasone, can cause rare but severe vestibular ototoxicity when the eardrum is perforated. This risk highlights the need for caution with these ear treatments.

Area of Science:

  • Ototolaryngology
  • Pharmacology
  • Neuroscience

Background:

  • Topical aminoglycoside ear drops are considered potentially ototoxic if used with a perforated tympanic membrane.
  • Clinical ototoxicity from these drops is generally considered rare.

Observation:

  • This study presents nine new cases (12 ears) of iatrogenic topical vestibulotoxicity from prolonged use of Garasone (gentamicin and betamethasone).
  • This represents the largest reported series of such cases in the English literature.
  • Five previously reported cases and four additional new cases of topical ototoxicity were also reviewed.

Findings:

  • The observed toxicity was predominantly vestibular, affecting balance, rather than cochlear, affecting hearing.
  • While unilateral cases showed compensation, bilateral cases resulted in severe disability.

Related Experiment Videos

  • The findings suggest a significant risk of vestibular damage from topical gentamicin in perforated ears.

    • Implications:

    • Clinicians should exercise extreme caution when prescribing topical aminoglycoside ear drops, especially Garasone, in patients with tympanic membrane perforations.
    • The potential for severe, permanent vestibular dysfunction necessitates careful patient selection and monitoring.
    • These findings may influence prescribing guidelines and patient counseling regarding the risks of topical ototoxicity.