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Drug delivery to the ear

    E Hoskison

    Department of Otorhinolaryngology, Head & Neck Surgery, Nottingham University Hospitals NHS Trust, Nottingham, NG7 2UH, UK

    NIHR Nottingham Hearing Biomedical Research Unit, Nottingham, UK

    ,
    M Daniel

    Department of Otorhinolaryngology, Head & Neck Surgery, Nottingham University Hospitals NHS Trust, Nottingham, NG7 2UH, UK

    NIHR Nottingham Hearing Biomedical Research Unit, Nottingham, UK

    Biomaterials-Related Infection Group, Division of Orthopaedic & Accident Surgery, University of Nottingham, UK

    ,
    S Al-Zahid

    Department of Otorhinolaryngology, Head & Neck Surgery, Nottingham University Hospitals NHS Trust, Nottingham, NG7 2UH, UK

    Biomaterials-Related Infection Group, Division of Orthopaedic & Accident Surgery, University of Nottingham, UK

    ,
    KM Shakesheff

    The Wolfson Centre for Stem Cells, Tissue Engineering & Modelling (STEM), The University of Nottingham, UK

    ,
    R Bayston

    Biomaterials-Related Infection Group, Division of Orthopaedic & Accident Surgery, University of Nottingham, UK

    Surgical Infection Head, Biomaterials-Related Infection Group, School of Clinical Sciences, Nottingham University Hospitals, UK

    &
    JP Birchall

    * Author for correspondence

    Department of Otorhinolaryngology, Head & Neck Surgery, Nottingham University Hospitals NHS Trust, Nottingham, NG7 2UH, UK.

    Published Online:https://doi.org/10.4155/tde.12.130

    Drug delivery to the ear is used to treat conditions of the middle and inner ear such as acute and chronic otitis media, Ménière’s disease, sensorineural hearing loss and tinnitus. Drugs used include antibiotics, antifungals, steroids, local anesthetics and neuroprotective agents. A literature review was conducted searching Medline (1966–2012), Embase (1988–2012), the Cochrane Library and Ovid (1966–2012), using search terms ‘drug delivery’, ‘middle ear’, ‘inner ear’ and ‘transtympanic’. There are numerous methods of drug delivery to the middle ear, which can be categorized as topical, systemic (intravenous), transtympanic and via the Eustachian tube. Localized treatments to the ear have the advantages of targeted drug delivery allowing higher therapeutic doses and minimizing systemic side effects. The ideal scenario would be a carrier system that could cross the intact tympanic membrane loaded with drugs or biochemical agents for the treatment of middle and inner ear conditions.

    Papers of special note have been highlighted as: ▪ of interest ▪▪ of considerable interest

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