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Effect and Biocompatibility of a Cross-Linked Hyaluronic Acid and Polylactide-co-glycolide Microcapsule Vehicle in Intratympanic Drug Delivery for Treating Acute Acoustic Trauma
Authors:Jung-Ah Cho  Bong Jik Kim  Yu-Jung Hwang  Shin-Wook Woo  Tae-Soo Noh  Myung-Whan Suh
Affiliation:1.Department of Otorhinolaryngology–Head and Neck Surgery, Seoul National University Hospital, Seoul 03080, Korea; (J.-A.C.); (Y.-J.H.); (S.-W.W.); (T.-S.N.);2.Department of Otolaryngology–Head and Neck Surgery, College of Medicine, Chungnam National University, Daejeon 35015, Korea;3.Department of Otolaryngology–Head and Neck Surgery, Chungnam National University Sejong Hospital, Sejong 30099, Korea
Abstract:The treatment of acute hearing loss is clinically challenging due to the low efficacy of drug delivery into the inner ear. Local intratympanic administration of dexamethasone (D) and insulin-like growth factor 1 (IGF1) has been proposed for treatment, but they do not persist in the middle ear because they are typically delivered in fluid form. We developed a dual-vehicle drug delivery system consisting of cross-linked hyaluronic acid and polylactide-co-glycolide microcapsules. The effect and biocompatibility of the dual vehicle in delivering D and IGF1 were evaluated using an animal model of acute acoustic trauma. The dual vehicle persisted 10.9 times longer (8.7 days) in the middle ear compared with the control (standard-of-care vehicle, 0.8 days). The dual vehicle was able to sustain drug release over up to 1 to 2 months when indocyanine green was loaded as the drug. One-third of the animals experienced an inflammatory adverse reaction. However, it was transient with no sequelae, which was validated by micro CT findings, endoscopic examination, and histological assessment. Hearing restoration after acoustic trauma was satisfactory in both groups, which was further supported by comparable numbers of viable hair cells. Overall, the use of a dual vehicle for intratympanic D and IGF1 delivery may maximize the effect of drug delivery to the target organ because the residence time of the vehicle is prolonged.
Keywords:acute acoustic trauma   drug delivery   hyaluronic acid   microcapsule   dexamethasone   hearing loss
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