
Перспективные методы лечения нейросенсорной тугоухости. Решение вопросов доставки лекарственных средств
Журнал: Вестник оториноларингологии. 2026;91(2):78-83.
DOI: 10.17116/otorino20269102178
Прочитано: 485 раз
Резюме
Обзор литературы посвящен современным методам доставки лекарств во внутреннее ухо, которые позволяют повысить эффективность лечения и снизить риск побочных эффектов. Рассматриваются системные, транстимпанальные и интракохлеарные пути введения препаратов, а также их преимущества и недостатки. Обсуждаются новые технологии, такие как гидрогели и наночастицы, обеспечивающие длительное и целенаправленное поступление медикаментов без необходимости хирургического вмешательства. Представлены биофизические методы, позволяющие доставлять лекарства неинвазивно и с высокой точностью.
Ключевые слова
- хроническая нейросенсорная тугоухость
- нанотехнологии
- микроиглы
- магнитные наночастицы
- биофизические методы
Дата поступления: 30.06.2025
Дата принятия в печать: 05.11.2025
Дата публикации: 12.05.2026
- Tambs K. Moderate Effects of Hearing Loss on Mental Health and Subjective Well-Being: Results from the Nord-Trøndelag Hearing Loss Study. Psychosomatic Medicine. 2004;66(5):776-782. https://doi.org/10.1097/01.psy.0000133328.03596.fb
- Блоцкий А.А., Карпищенко С.А. Неотложные состояния в оториноларингологии. СПб.: Диалог; 2009.
- Пальчун В.Т., Магомедов М.М., Лучихин Л.А. Оториноларингология: учебник для студентов медицинских вузов. 2-е изд., испр. и доп. М.: ГЭОТАР-Медиа; 2008.
- Burns JC, Stone JS. Development and regeneration of vestibular hair cells in mammals. Seminars in Cell and Developmental Biology. 2017;65:96-105. https://doi.org/10.1016/j.semcdb.2016.11.001
- Liu H, Hao J, Li KS. Current strategies for drug delivery to the inner ear. Acta Pharmaceutica Sinica B. 2013;3(2):86-96. https://doi.org/10.1016/j.apsb.2013.02.003
- Shi X. Pathophysiology of the cochlear intrastrial fluid-blood barrier. Hearing Research. 2016;338:52-63. https://doi.org/10.1016/j.heares.2016.01.010
- Bird PA, Begg EJ, Zhang M, Keast AT, Murray DP, Balkany TJ. Intratympanic versus intravenous delivery of methylprednisolone to cochlear perilymph. Otology and Neurotology. 2007;28(8):1124-1130. https://doi.org/10.1097/mao.0b013e31815aee21
- Chandrasekhar SS. Intratympanic dexamethasone for sudden sensorineural hearing loss: clinical and laboratory evaluation. Otology and Neurotology. 2001;22:18-23. https://doi.org/10.1097/00129492-200101000-00005
- Ding S, Xie S, Chen W, Wen L, Wang J, Yang F, Chen G. Is oval window transport a royal gate for nanoparticle delivery to vestibule in the inner ear? European Journal of Pharmaceutical Sciences. 2019;126:11-22. https://doi.org/10.1016/j.ejps.2018.02.031
- Kelso CM, Watanabe H, Wazen JM, Bucher T, Qian ZJ, Olson ES, Lalwani AK. Microperforations significantly enhance diffusion across round window membrane. Otology and Neurotology. 2015;36(4):694-700. https://doi.org/10.1097/mao.0000000000000629
- Santimetaneedol A, Wang Z, Arteaga D N, Aksit A, Prevoteau C, Yu M, Kysar JW. Small molecule delivery across a perforated artificial membrane by thermoreversible hydrogel poloxamer 407. Colloids and Surfaces. B, Biointerfaces. 2019;182:110300. https://doi.org/10.1016/j.colsurfb.2019.06.030
- Aksit A, Arteaga DN, Arriag, M, Wang X, Watanabe H, Kasza KE, Kysar J. W In-vitro perforation of the round window membrane via direct 3-D printed microneedles. Biomedical Microdevices. 2018;20:1-12. https://doi.org/10.1007/s10544-018-0287-3
- Wazen JM, Stevens JP, Watanabe H, Kysar JW, Lalwani AK. Silver/silver chloride microneedles can detect penetration through the round window membrane. Biomedical Materials Research. Part B: Applied Biomaterials. 2017;105:307-311. https://doi.org/10.1002/jbm.b.33557
- Yu M, Arteaga DN, Aksit A, Chiang H, Olson ES, Kysar JW, Lalwani AK. Anatomical and functional consequences of microneedle perforation of round window membrane. Otology and Neurotology. 2019;41(2):e280-e287. https://doi.org/10.1097/mao.0000000000002491
- Salt AN, Ma Y. Quantification of solute entry into cochlear perilymph through the round window membrane. Hearing Research. 2001;154(1-2):88-97. https://doi.org/10.1016/S0378-5955(01)00223-4
- Lichtenhan JT, Hartsock JJ, Gill RM, Guinan JJ, Salt AN. The Auditory Nerve Overlapped Waveform (ANOW) Originates in the Cochlear Apex. Journal of the Association for Research in Otolaryngology: JARO. 2014;15(3):395-411. https://doi.org/10.1007/s10162-014-0447-y
- Hütten M, Dhanasingh A, Hessler R, Stöver T, Esser KH, Möller M, Scheper V. In vitro and in vivo evaluation of a hydrogel reservoir as a continuous drug delivery system for inner ear treatment. PloS One. 2014;9(8):e104564. https://doi.org/10.1002/smll.202106591
- Mfoafo K, Mittal R, Eshraghi A, Omidi Y, Omidian H. Improved inner ear drug delivery using hydrogel carriers. Journal of Drug Delivery Science and Technology. 2023;79:104086. https://doi.org/10.1016/j.jddst.2022.104086
- Paulson DP, Abuzeid W, Jiang H, Oe T, O’Malley BW, Li D. A Novel Controlled Local Drug Delivery System for Inner Ear Disease. The Laryngoscope. 2008;118(4):706-711. https://doi.org/10.1097/mlg.0b013e31815f8e41
- Xu L, Heldrich J, Wang H, Yamashita T, Miyamoto S, Li A, Li DA. Controlled and Sustained Local Gentamicin Delivery System for Inner Ear Applications. Otology and Neurotology. 2010;31(7):1115-1121. https://doi.org/10.1097/mao.0b013e3181eb32d1
- Dumortier G, Grossiord JL, Agnely F, Chaumeil JC. A review of poloxamer 407 pharmaceutical and pharmacological characteristics. Pharmaceutical Research. 2006;23:2709-2728. https://doi.org/10.1007/s11095-006-9104-4
- Eshraghi AA, Ahmed J, Krysiak E, Ila K, Ashman P, Telischi FF, Valendia S. Clinical, surgical, and electrical factors impacting residual hearing in cochlear implant surgery. Acta Oto-Laryngologica. 2016;137(4):384-388. https://doi.org/10.1080/00016489.2016.1256499
- Arambula A, Arnoldner C, Warnecke A, Staecker H. The Augmented Cochlear Implant: a Convergence of Drugs and Cochlear Implantation for the Treatment of Hearing Loss. Current Otorhinolaryngology Reports. 2022;10:349-356. https://doi.org/10.1007/s40136-022-00426-1
- Szeto B, Chiang H, Valentini C, Yu M, Kysar JW, Lalwani AK. Inner ear delivery: Challenges and opportunities. Laryngoscope Investigative Otolaryngology. 2020;5(1):122-131. https://doi.org/10.1002/lio2.336
- Kim DK. Nanomedicine for inner ear diseases: a review of recent in vivo studies. BioMed Research International. 2017;(1):3098230. https://doi.org/10.1155/2017/3098230
- Arslan FB, Ozturk Atar K, Calis S. Antibody-mediated drug delivery. International Journal of Pharmacology. 2021;596:120268. https://doi.org/10.1016/j.ijpharm.2021.120268
- Agrahari V, Agrahari V, Mitra AK. Inner Ear Targeted Drug delivery: What Does the Future hold? Therapeutic Delivery. 2017;8(4):179-184. https://doi.org/10.4155/tde-2017-0001
- Kumar KV. Targeted delivery of nanomedicines. International Scholarly Research Notices. 2012;2012(1):571394. https://doi.org/10.5402/2012/571394
- Attia MF, Anton N, Wallyn J, Omran Z, Vandamme TF. An overview of active and passive targeting strategies to improve the nanocarriers efficiency to tumour sites. Journal of Pharmacy and Pharmacology. 2019;71(8):1185-1198. https://doi.org/10.1111/jphp.13098
- Friedman AD, Claypool SE, Liu R. The smart targeting of nanoparticles. Current Pharmaceutical Design. 2013;19(35):6315-6329. https://doi.org/10.2174/13816128113199990375
- Lu XY, Wu DC, Li ZJ, Chen GQ. Polymer nanoparticles. Progress in Molecular Biology and Translational Science. 2011;104:299-323. https://doi.org/10.1016/B978-0-12-416020-0.00007-3
- Lian Z, Yu, H, Lai J, Wen L, Chen G. An Easy-To-Prepare Microshotgun for Efficient Transmembrane Delivery by Powering Nanoparticles. Journal of Controlled Release. 2020;321:119-131. https://doi.org/10.1016/j.jconrel.2020.02.016
- Yang KJ, Son J, Jung SY, Yi G, Yoo J, Kim DK, Koo H. Optimized phospholipid-based nanoparticles for inner ear drug delivery and therapy. Biomaterials. 2018;171:133-143. https://doi.org/10.1016/j.biomaterials.2018.04.038
- Lajud SA, Nagda DA, Qiao P, Tanaka N, Civantos A, Gu R, Li D. A novel chitosan-hydrogel-based nanoparticle delivery system for local inner ear application. Otology and Neurotology. 2015;36(2):341-347. https://doi.org/10.1097/MAO.0000000000000445
- Kopke RD, Wassel RA, Mondalek F, Grady B, Chen K, Liu J, Gibson D, Dormer KJ. Magnetic nanoparticles: inner ear targeted molecule delivery and middle ear implant. Audiology and Neuro-Otology. 2006;11:123-133. https://doi.org/10.1159/000090685
- Ramaswamy B, Roy S, Apolo AB, Shapiro B, Depireux DA. Magnetic nanoparticle mediated steroid delivery mitigates Cisplatin induced hearing loss. Frontiers in Cellular Neuroscience. 2017;11:268. https://doi.org/10.3389/fncel.2017.00268
- Kayyali MN, Wooltorton JR, Ramsey AJ, Lin M, Chao TN, Tsourkas A, O’Malley BW, Li D. A novel nanoparticle delivery system for targeted therapy of noise induced hearing loss. Journal of Controlled Release. 2018;279:243-250. https://doi.org/10.1016/j.jconrel.2018.04.028
- Kuang X, Zhou S, Guo W, Wang Z, Sun Y, Liu H. SS-31 peptide enables mitochondrial targeting drug delivery: a promising therapeutic alteration to prevent hair cell damage from aminoglycosides. Drug Delivery. 2017;24(1):1750-1761. https://doi.org/10.1080/10717544.2017.1402220
- Кунельская Н.Л. Реабилитация пациентов с различными формами нейросенсорной тугоухости. РМЖ. 2011;19(24):1478-1482.
- Kunelskaya NL. Rehabilitation of patients with various forms of sensorineural hearing loss. RMZh. 2011;19(24):1478-1482. (In Russ.).
- Кунельская Н.Л., Левина Ю.В., Байбакова Е.В., Шурпо В.И. Субъективный ушной шум: современные тенденции и перспективы. Вестник оториноларингологии. 2019;84(6):54-60.
- Kunel’skaya NL, Levina IuV, Baybakova EV, Shurpo VI. Tinnitus — current trends and prospects. Russian Bulletin of Otorhinolaryngology. 2019;84(6):54-60. (In Russ.). https://doi.org/10.17116/otorino20198406154
- Крюков А.И., Кунельская Н.Л., Шершунова Е.А., Ребров И.Е., Ямщиков В.А., Гаров Е.В., Царапкин Г.Ю., Мищенко В.В. Топическое введение препаратов во внутреннее ухо. Современное состояние проблемы и перспективы развития. Вестник оториноларингологии. 2019;84(5):6-14.
- Krukov AI, Kunel’skaya NL, Shershunova EA, Rebrov IE, Yamshchikov VA, Garov EV, Tsarapkin GYu, Mishchenko VV. Topical drug administration to the inner ear. Modern state of the problem and development perspectives. Russian Bulletin of Otorhinolaryngology. 2019;84(5):6-14. (In Russ.). https://doi.org/10.17116/otorino2019840516
Рекомендуем статьи по данной теме:
Эффективность фармакофизического воздействия у пациентов с субъективным ушным шумом на фоне хронической нейросенсорной тугоухости.Вестник оториноларингологии. 2025;90(6):24-28
Эндауральный фоноэлектрофорез с дексаметазоном в лечении болезни Меньера.Вестник оториноларингологии. 2025;90(6):19-23


