Nanocarriers for Inner Ear Disease Therapy

Hearing loss is a common disease due to sensory loss caused by the diseases in the inner ear. The development of delivery systems for inner ear disease therapy is important to achieve high efficiency and reduce side effects. Currently, traditional drug delivery systems exhibit the potential to be used for inner ear disease therapy, but there are still some drawbacks. As nanotechnology is developing these years, one of the solutions is to develop nanoparticle-based delivery systems for inner ear disease therapy. Various nanoparticles, such as soft material and inorganic-based nanoparticles, have been designed, tested, and showed controlled delivery of drugs, improved targeting property to specific cells, and reduced systemic side effects. In this review, we summarized recent progress in nanocarriers for inner ear disease therapy. This review provides useful information on developing promising nanocarriers for the efficient treatment of inner ear diseases and for further clinical applications for inner ear disease therapy.

Imaging of inner ear malformations: a primer for radiologists

In the multidisciplinary management of patients with inner ear malformations (IEMs), the correct diagnosis makes the differences in terms of clinical and surgical treatment. The complex anatomical landscape of the inner ear, comprising several small structures, makes imaging of this region particularly challenging for general radiologists. Imaging techniques are important for identifying the presence and defining the type of IEM and the cochlear nerve condition. High-resolution magnetic resonance imaging (MRI) sequences and high-resolution computed tomography (HRCT) are the mainstay imaging techniques in this area. Dedicated MRI and HRCT protocols play an important role in the diagnosis and treatment of patients with inner ear disease. The most suitable technique should be selected depending on the clinical setting. However, in cases of congenital malformation of the inner ear, these techniques should be considered complementary. Since prompt intervention has a positive impact on the treatment outcomes, early diagnosis of IEMs is very important in the management of deaf patients. This article reviews the key concepts of IEMs for clinical radiologists by focusing on recent literature updates, discusses the principal imaging findings and clinical implications for every IEM subgroup, thus providing a practical diagnostic approach.

Clinical Characteristics of Patients With Dizziness/Vertigo Accompanied by Posterior Semicircular Canal Hypofunction

Objective: To investigate the clinical characteristics of patients with dizziness/vertigo accompanied by loss of the posterior canal(s) (LPC).Methods: Clinical data of 23 patients with LPC were collected. We determined video-head-impulse test (vHIT) gains of all six semicircular canals and correlated vHIT findings with other vestibulo-cochlear tests, including caloric test, ocular and cervical vestibular-evoked myogenic potentials (oVEMP, cVEMP), pure tone audiometry (PTA), and analyzed the differences in clinical manifestations of patients with LPC with different etiologies.Results: LPC was identified in 23 patients. At the time of disease onset, most patients presented with dizziness (47.8%) and vertigo (30.4%) only, and some patients (21.7%) complained of unsteadiness. Among these 23 patients with LPC, there were 14 (60.9%) patients of isolated LPC (ILPC), 21 (91.3%) patients of unilateral LPC (ULPC), and 2 (8.7%) patients of bilateral LPC (BLPC). (1) Among 14 patients with ILPC, 13 (92.9%) patients had unilateral ILPC, the rate of ipsilesional impairment on caloric test, or oVEMP/cVEMP test or PTA ipsilesionally was 53.8% (7/13) in patients with unilateral ILPC. The causes of unilateral ILPC were vertigo/dizziness of unclear origin (38.5%), labyrinthine infarction (15.4%), vestibular migraine (15.4%), and other diseases (30.8%); (2) among 21 patients with ULPC, 7 patients (33.3%) were accompanied with horizontal semicircular canal hypofunction ipsilesionally, the abnormal rate of caloric test, or oVEMP/cVEMP tests or PTA ipsilesionally was 57.1%. The causes of ULPC were vertigo/dizziness of unclear origin (33.3%), autoimmune inner ear disease (14.3%), labyrinthine infarction (14.3%), vestibular neuritis (9.5%), vestibular migraine (9.5%), and other diseases (19.0%); (3) among two patients with BLPC, one patient presented with unsteadiness, the causes of BLPC were vestibular paroxysmia and autoimmune inner ear disease.Conclusion: vHIT is a fast and effective method for assessing LPC, which can be used to detect isolated PC dysfunction. The causes of ILPC were peripheral origin or central origin. Patients with ILPC and ULPC mostly presented with dizziness/vertigo, and ULPC was often accompanied by ipsilateral vestibulo-cochlear impairment.

Study of the effect of mobile phones on hearing

<p><strong>Background</strong>:<strong> </strong>The effect of mobile phone radiation on human health is the subject of recent interest and study as a result of the enormous increase in mobile phone usage throughout the world. The present study was designed with an objective to study the effect of mobile phones on hearing.</p><p><strong>Methods</strong>: This cross sectional study involved cases in the age group of 18 to 45 years attending the out-patient department of ENT at Chhatrapati Shivaji Subharti hospital, Meerut. A total of 85 patients (mobile phone users) were taken for the study October 2018 to July 2020. Subjects with usage of mobile phones (smart phones) for a minimum of 2 hours a day and a minimum of 1 year duration (with or without ear phones), normal healthy individuals with no systemic disease, normal tympanic membrane with no prior external, middle/inner ear disease or discharge or trauma and subjects with type a tympanogram (on tympanometry) were included in the study. Degree of deafness was graded according to WHO classification, 1980</p><p><strong>Results</strong>: Statistically significant p value was observed (&lt;0.001) while comparing SNHL with hours of exposure and years of exposure. Statistically significant p value was observed (&lt;0.05) while comparing hours of exposure with Tinnitus. Statistically insignificant p value was observed while comparing hours and years of exposure with other associated complaints; aural fullness, ear ache (otalgia) and warmth sensation in ear.</p><p><strong>Conclusions</strong>: The present study shows an increase in the hearing threshold of the ear exposed to the prolonged use of mobile phones.</p>

STEP TOWARDS UNDERSTANDING THE MYSTERY OF MENIERE’S DISEASE THROUGH AYURVEDA

Meniere’s disease is an inner ear disease characterised by episodes of Vertigo, fluctuating sensorineural hearing loss and Tinnitus, associated with Aural pressure Drop attacks (falls without loss of consciousness), Nystagmus, Headache and Nausea. Relapsing nature of the disease hampers the quality of life in patients. And also affects the psychosocial status of the patient. The main pathology occurs as the result of endo-lymphatic system distension, caused by the excessive accumulation of endolymph. This can result from excessive production or reduced absorption of endolymph or both. By knowing the pathology of the Meniere’s disease, clinical features and signs we can consider Karna Nada, Karna Kshweda, (Tinnitus) Badhirya (Hearing Loss) and Bhrama (vertigo) into consideration in which we encounter the vitiation of Karnagata Tarpaka Kapha and Vata. Hence treatment should be aimed at Agni deepana, Vata Anulomana, Vata Kapha Shamana. Nasya Karma, Karna Poorana, Shamana Snehapana, Snigdha Virechana can be employed in the management of Meniere’s Disease.

STEP TOWARDS UNDERSTANDING THE MYSTERY OF MENIERE’S DISEASE THROUGH AYURVEDA

Meniere’s disease is an inner ear disease characterised by episodes of Vertigo, fluctuating sensorineural hearing loss and Tinnitus, associated with Aural pressure Drop attacks (falls without loss of consciousness), Nystagmus, Headache and Nausea. Relapsing nature of the disease hampers the quality of life in patients. And also affects the psychosocial status of the patient. The main pathology occurs as the result of endo-lymphatic system distension, caused by the excessive accumulation of endolymph. This can result from excessive production or reduced absorption of endolymph or both. By knowing the pathology of the Meniere’s disease, clinical features and signs we can consider Karna Nada, Karna Kshweda, (Tinnitus) Badhirya (Hearing Loss) and Bhrama (vertigo) into consideration in which we encounter the vitiation of Karnagata Tarpaka Kapha and Vata. Hence treatment should be aimed at Agni deepana, Vata Anulomana, Vata Kapha Shamana. Nasya Karma, Karna Poorana, Shamana Snehapana, Snigdha Virechana can be employed in the management of Meniere’s Disease.

Autoimmune Inner Ear Disease among Patients with Selective IgA Deficiency

<b><i>Objectives:</i></b> Autoimmune inner ear disease (AIED) is a distinct clinical entity from sudden sensorineural hearing loss. The purpose of this study was to investigate the clinical characteristics of AIED in patients with selective IgA deficiency (sIgAD). <b><i>Materials and Methods:</i></b> This retrospective observational study was based on data from the Leumit Healthcare Services database in Israel. We searched all subjects aged ≥12 years who had undergone serum total IgA measurements during 2004–2014 for any reason. The sIgAD patients included all subjects with serum IgA of ≤7 mg/dL (0.07 g/L). A control group was randomly sampled from the full study population (<i>n</i> ≈ 730,000) with a case-control ratio of 10 controls for each case (1:10). <b><i>Results:</i></b> Among 347 subjects with sIgAD, we identified 9 patients with concomitant AIED (sIgAD + AIED group). This group was characterized by a higher prevalence of allergic diseases (8 patients; 88.9%) than sIgAD patients without AEID (sIgAD + AIED group; 153 patients; 45.2%; <i>p</i> = 0.014). Both systemic diseases (3 patients; 33.3%) and organ-specific autoimmune diseases (7 patients; 77.8%) were more prevalent in the sIgAD + AIED group (sIgAD + AIED group: 19 patients 5.5%, <i>p</i> = 0.015; sIgAD − AEID group: 76 patients, 21.9%, <i>p</i> &#x3c; 0.001), with an OR of 8.39 (1.94–36.19; <i>p</i> = 0.004). sIgAD patients with and without AIED were characterized by a higher prevalence of documented episodes of acute otitis media, allergic diseases, and autoimmune diseases than the control group. <b><i>Conclusion:</i></b> The study exposes a significant association between AIED and sIgAD. We believe that sIgAD has to be excluded in AIED patients.