Gentamicin delivery to the inner ear: does endolymphatic hydrops matter?
Keywords: 
Middle ear application of gentamicin
Common medical treatment
Ménière’s disease
Issue Date: 
2018
Publisher: 
Public Library of Science
ISSN: 
1932-6203
Note: 
This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Citation: 
Marques-Vidal, P. (Pedro); Duan, M. (Maoli); Perez-Fernandez, N. (Nicolás); et al. "Gentamicin delivery to the inner ear: does endolymphatic hydrops matter?". Plos one. 13 (11), 2018, e0207467
Abstract
Introduction Middle ear application of gentamicin is a common medical treatment for uncontrolled Ménière’s disease. The objective of the study was to evaluate the impact of endolymphatic hydrops on inner ear delivery. Methods Perilymph gentamicin concentrations and correlation with endolymphatic hydrops in an animal model were assessed. A group of 24 guinea pigs was submitted to surgical obstruction of the endolymphatic sac and duct of the right ear. Gentamicin was applied either to the right ear’s round window niche or through a transtympanic injection. Perilymph specimens were collected at different times. Histologic morphometry was used to evaluate both turn-specific and overall hydrops degree. Results In animals with endolymphatic hydrops, lower concentrations of gentamicin were observed after 20 or 120 minutes of exposure and in both types of administration, when compared to controls. This difference reached statistical significance in the round window niche application group (Mann-Whitney, p = 0,007). A negative correlation between perilymphatic gentamicin concentration and hydrops degree could be observed in both groups, after 120 minutes of exposure (Spearman correlation, round window niche p<0,001; TT p = 0,005). Conclusions The study indicates that the endolymphatic hydrops degree has a negative interference on the delivery of gentamicin into the inner ear following middle ear application.

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