HISTOPATHOLOGICAL EVALUATION OF OTOTOXIC SIDE EFFECTS OF ANTIFUNGAL DRUGS TOPICALLY APPLIED TO THE MIDDLE EAR
1Sağlık Bilimleri Üniversitesi Tepecik Eğitim ve Araştırma Hastanesi, KBB Kliniği, İzmir, Türkiye2Celal Bayar Üniversitesi Tıp Fakültesi, KBB Anabilim Dalı, Manisa, Türkiye
3Celal Bayar Üniversitesi Tıp Fakültesi, Histoloji Anabilim Dalı, Manisa, Türkiye Introduction: There is a lack of data regarding ototoxicity of topically applied antimycotics. In this study, the ototoxicity of tolnaftate, sulcanosole, bifonasole and nystatin was histopathologically studied.
Material and Method: 35 guinea pigs were divided into 5 goups and tolnaftate, sulcanosole, bifonasole, nystatin and neomicin (positive control) were applied. Drugs was injected into the right tympanic cavity, three times in a week. Left ears were evaluated as a negative control group. Animals were sacrified two weeks after treatment and the cochleas were examined under light microscopy. The percentage of apoptotic cells in spiral limbus and spiral ganglion were determined by TUNEL method.
Results: The percentage of apoptotic cells were higher in ears which tolnaftat and bifonasole were applied, than in ears which sulconasole and nystatin were applied. These findings indicated that antimycotics might cause ototoxicity by apoptosis, this effect can be seen not only in spiral limbus and but also in spiral ganglion.
Conclusion: Antifungal drugs may cause ototoxicity. In cases of the tympanic membrane perforation, topical application of sulcanasole and nystatine should be preferred since their ototoxic effects are much less.
Keywords : Otomycosis, antifungal treatment, ototoxicity, apopitozis