Literature DB >> 17119332

Cochlear pharmacokinetics with local inner ear drug delivery using a three-dimensional finite-element computer model.

Stefan K Plontke1, Norbert Siedow, Raimund Wegener, Hans-Peter Zenner, Alec N Salt.   

Abstract

HYPOTHESIS: Cochlear fluid pharmacokinetics can be better represented by three-dimensional (3D) finite-element simulations of drug dispersal.
BACKGROUND: Local drug deliveries to the round window membrane are increasingly being used to treat inner ear disorders. Crucial to the development of safe therapies is knowledge of drug distribution in the inner ear with different delivery methods. Computer simulations allow application protocols and drug delivery systems to be evaluated, and may permit animal studies to be extrapolated to the larger cochlea of the human.
METHODS: A finite-element 3D model of the cochlea was constructed based on geometric dimensions of the guinea pig cochlea. Drug propagation along and between compartments was described by passive diffusion. To demonstrate the potential value of the model, methylprednisolone distribution in the cochlea was calculated for two clinically relevant application protocols using pharmacokinetic parameters derived from a prior one-dimensional (1D) model. In addition, a simplified geometry was used to compare results from 3D with 1D simulations.
RESULTS: For the simplified geometry, calculated concentration profiles with distance were in excellent agreement between the 1D and the 3D models. Different drug delivery strategies produce very different concentration time courses, peak concentrations and basal-apical concentration gradients of drug. In addition, 3D computations demonstrate the existence of substantial gradients across the scalae in the basal turn.
CONCLUSION: The 3D model clearly shows the presence of drug gradients across the basal scalae of guinea pigs, demonstrating the necessity of a 3D approach to predict drug movements across and between scalae with larger cross-sectional areas, such as the human, with accuracy. This is the first model to incorporate the volume of the spiral ligament and to calculate diffusion through this structure. Further development of the 3D model will have to incorporate a more accurate geometry of the entire inner ear and incorporate more of the specific processes that contribute to drug removal from the inner ear fluids. Appropriate computer models may assist in both drug and drug delivery system design and can thus accelerate the development of a rationale-based local drug delivery to the inner ear and its successful establishment in clinical practice. Copyright 2007 S. Karger AG, Basel.

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Year:  2006        PMID: 17119332      PMCID: PMC1779502          DOI: 10.1159/000097246

Source DB:  PubMed          Journal:  Audiol Neurootol        ISSN: 1420-3030            Impact factor:   1.854


  27 in total

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Authors:  H J Beer; M Bornitz; H J Hardtke; R Schmidt; G Hofmann; U Vogel; T Zahnert; K B Hüttenbrink
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3.  Ablation therapy for the relief of Ménière's disease.

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Review 4.  Local inner-ear drug delivery and pharmacokinetics.

Authors:  Alec N Salt; Stefan K R Plontke
Journal:  Drug Discov Today       Date:  2005-10-01       Impact factor: 7.851

5.  Outcomes research analysis of continuous intratympanic glucocorticoid delivery in patients with acute severe to profound hearing loss: basis for planning randomized controlled trials.

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8.  Communication between the perilymphatic scalae and spiral ligament visualized by in vivo MRI.

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9.  Perilymph sampling from the cochlear apex: a reliable method to obtain higher purity perilymph samples from scala tympani.

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10.  [27 years experiences with transtympanic aminoglycoside treatment of Menière's disease].

Authors:  G Lange
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  15 in total

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Review 4.  Intracochlear drug delivery systems.

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6.  Systemic, intratympanic and combined administration of steroids for sudden hearing loss. A prospective randomized multicenter trial.

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Review 7.  The role of glucocorticoids for spiral ganglion neuron survival.

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8.  Dexamethasone concentration gradients along scala tympani after application to the round window membrane.

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9.  Blocking the glucocorticoid receptor with RU-486 does not prevent glucocorticoid control of autoimmune mouse hearing loss.

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10.  Influence of bone morphogenetic protein-2 on spiral ganglion neurite growth in vitro.

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