摘要
目前全球已有超过30万人植入人工耳蜗,随着植入适应证的放宽,植入时、植入后如何良好保留患者的残余听力和内耳原有微结构及功能,如何安全有效地借助药物减轻术后炎性反应和纤维化、保留残余听力、减少毛细胞和螺旋神经节细胞的凋亡等已成为该领域的研究热点。由于血-迷路屏障的存在,人工耳蜗植入围手术期静脉应用激素类药物难以在内耳达到足够的药物浓度,而过度提高静脉给药剂量又会造成更严重的全身不良反应,而且部分患者因自身基础疾病限制了激素类药物的使用。因此,内耳局部给药的研究在近年受到国内外学者的重视。本文将内耳局部给药方法分为鼓室内直接给药、鼓室内缓释载体给药、耳蜗内给药和人工耳蜗植入电极的修饰四大类,并分别就其研究结果及前沿进展做一综述。
Nowadays, more than 300 000 deaf people around the world benefit from cochlea implantation. With the extension of cochlear implantation indications, it has become a research focus for how to apply the anti-inflammatory and anti-fibrotic drugs safely and effectively to better retain residual hearing, as well as to protect hair cells and the spiral ganglion cells from apoptosis. Due to the blood-labyrinth barrier, perioperative systemic steroids are often unable to achieve satisfactory drug concentration in the inner ear. Also, given that higher doses of steroids will cause more serious side effects and sometimes steroids are strictly limited to apply on some patients with certain diseases, the attention has been attracted on topical drug delivery to the inner ear. In this review, the methods of topical drug delivery to the inner ear are divided into four categories: transtympanic injection of liquid solutions, tympanic implantation of drug delivery systems, intracochlear injection and modified implant electrode. The results in each category and up to date progress are reviewed.
作者
于浩然
贾欢
杨军
Yu Haoran;Jia Huan;Yang Jun(Department of Otorhinolaryngology Head and Neck Surgery,Xinhua Hospital,Shanghai Jiaotong University School of Medicine,Shanghai 200092,China;Department of Otorhinolaryngology Head and Neck Surgery, Shanghai Ninth People's Hospital,Shanghai Jiaotong University School of Medicine,Shanghai 200011, China)
出处
《中华耳鼻咽喉头颈外科杂志》
CAS
CSCD
北大核心
2019年第1期69-72,共4页
Chinese Journal of Otorhinolaryngology Head and Neck Surgery
基金
国家自然科学基金(81200742)
上海市优秀学术带头人计划(16XD1402200)
上海市自然科学基金(17ZR1416100).
关键词
耳蜗植入术
耳
内
投药
局部
炎症
纤维化
Cochlear implantation
Ear, inner
Administration, topical
Inflammation
Fibrosis
