鼓室给药临床实践指南

Clinical practice guidelines for intratympanic drug delivery

摘要:

鼓室给药是一种常见的耳科局部给药方式，指通过将药物递送入中耳，经圆窗膜或卵圆窗扩散分布到内耳从而达到治疗或诊断效果。近年来，鼓室给药技术在耳科疾病的临床应用越来越广泛，主要包括突发性聋、梅尼埃病、分泌性中耳炎和自身免疫性内耳病等疾病的诊治。目前，国内外对鼓室给药的操作规范、适应证，尤其是给药时机及治疗方案尚未有统一标准。为了促进鼓室给药技术规范化，我们特组织了国内在鼓室给药领域经验丰富，有卓越建树中青年专家，基于临床经验和循证医学证据制定了鼓室给药临床实践指南。本指南从鼓室给药操作规范出发，系统总结了糖皮质激素鼓室给药、庆大霉素鼓室给药、鼓室内注射造影剂膜迷路MRI成像及其他药物鼓室给药四个方面，旨在指导并规范临床鼓室给药技术的应用。

Abstract:

Intratympanic drug delivery is a commonly used method for administering topical drugs in otology. It involves directly delivering drugs into the middle ear, allowing them to diffuse to the inner ear through the round window membrane or oval window. This method is employed to achieve therapeutic or diagnostic effects. In recent years, intratympanic drug delivery has become widely utilized in the diagnosis and treatment of various otological diseases including sudden sensorineural hearing loss, Meniere’s disease, secretory otitis media, and autoimmune inner ear diseases. However, there is currently no standardized protocol regarding the operation specifications, indications, timing of administration, and treatment plans for intratympanic drug delivery. In order to promote the standardization of intratympanic drug delivery, we have assembled a group of experienced and accomplished young and middle-aged domestic experts who possess extensive experience and notable achievements and formulated the clinical practice guidelines for intratympanic drug delivery based on clinical expertise and evidence-based medical researches. The guidelines primarily focus on four aspects of intratympanic drug delivery: glucocorticoids, gentamicin, intratympanic injection of contrast media, and other drugs. It provides a comprehensive and systematic summary of these aspects, with the goal of guiding and standardizing the clinical application of intratympanic drug delivery technology.