Case Report

Topical Ocular Drug Delivery to Inner Ear Disease and Sinusitis

Authors: Tatsuya Mimura, MD, Hideharu Funatsu, MD, Tomohiko Usui, MD, Satoru Yamagami, MD, Hidetaka Noma, MD, Shiro Amano, MD

Abstract

Oral steroids are the main therapy for sensorineural deafness. We present the rare case of a patient whose hearing loss associated with inflammation of the inner ear and chronic sinusitis were improved with topical steroid therapy. A 68-year-old male presented with scleritis in the left eye, inflammation of the inner ear and chronic sinusitis. He received oral prednisolone 10 mg/d. However, the oral prednisolone was discontinued due to severe side effects. Topical administration of 0.1% betamethasone sodium phosphate improved the scleritis and incidentally also relieved his symptoms of recurrent otitis and sinusitis after several days. Audiometry revealed recovered acoustic sensation in the right ear, from 50 dB to 20 dB, and in the left ear from 70 to 35 dB with 1,000 Hz. Topical ocular drug delivery of steroids may be effective for inner ear disease and sinusitis in patients with systemic side effects to oral steroids.


Key Points


* Oral steroids are the main therapy for sensorineural deafness.


* A topical steroid can relieve the symptoms of otitis and sinusitis through the lacrimal passage.


* Ocular drugs are rarely associated with systemic side effects.


* Ocular drug delivery is effective for inner ear disease and sinusitis in patients with systemic side effects to oral medications.

This content is limited to qualifying members.

Existing members, please login first

If you have an existing account please login now to access this article or view purchase options.

Purchase only this article ($25)

Create a free account, then purchase this article to download or access it online for 24 hours.

Purchase an SMJ online subscription ($75)

Create a free account, then purchase a subscription to get complete access to all articles for a full year.

Purchase a membership plan (fees vary)

Premium members can access all articles plus recieve many more benefits. View all membership plans and benefit packages.

References

1. Schimmer BP, Parker KL. Adrenocorticotropic hormone; adrenocortical steroids and their synthetic analogs; inhibitors of the synthesis and actions of adrenocortical hormones. In: Hardman JG, Limbird LE, Gilman AG, eds. Goodman and Gilman's the Pharmacological Basis of Therapeutics, 10th ed. New York, McGraw-Hill, 2001, p 1657.
 
2. Lee YC, Simamora P, Pinsuwan S, et al. Review on the systemic delivery of insulin via the ocular route. Int J Pharm 2002;233:1–18.
 
3. Baeyens V, Gurny R. Chemical and physical parameters to tears relevant for the design of ocular drug delivery formulations. Pharm Acta Helv 1997;72:191–202.
 
4. Ding S. Recent development in ophthalmic drug delivery. Pharm Sci Tech Today 1998;8:328–335.
 
5. Lang JC. Ocular drug delivery conventional ocular formulation. Adv Drug Deliv Rev 1995;16:39–43.
 
 6. Shell JW. Ophthalmic drug delivery systems. Surv Ophthalmol 1984;29:117–128.