Fasudil administration combined with a steroid for the treatment of idiopathic sudden sensorineural hearing loss.-effect of Rho-kinase inhibitor on cochlear ischemia-

DOI 6 References Open Access
  • Doi Katsumi
    Department of Otolaryngology, Osaka University Graduate School of Medicine
  • Nishimura Hiroshi
    Department of Otolaryngology, Osaka University Graduate School of Medicine
  • Kawashima Takayuki
    Department of Otolaryngology, Osaka University Graduate School of Medicine
  • Osaki Yasuhiro
    Department of Otolaryngology, Osaka University Graduate School of Medicine
  • Kubo Takeshi
    Department of Otolaryngology, Osaka University Graduate School of Medicine
  • Senba Osamu
    Department of otolaryngology, Osaka Kouseinenkin Hospital
  • Boku Hidenori
    Department of otolaryngology, Osaka Kouseinenkin Hospital
  • Hasegawa Taro
    Department of Otolaryngology, Yao Municipal Hospital
  • Shimizu Tomoyuki
    Department of Otolaryngology, Yao Municipal Hospital

Bibliographic Information

Other Title
  • 突発性難聴に対する塩酸ファスジル併用ステロイド治療の有用性―内耳循環障害とＲｈｏキナーゼの関連―
  • effect of Rho-kinase inhibitor on cochlear ischemia
  • 内耳循環障害とRhoキナーゼの関連

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Description

Fasudil, a potent Rho-kinase inhibitor, has been reported to reverse the endothelin-induced vasoconstriction of the spiral modiolar artery in the gerbil cochlea. We previously demonstrated that both endothelin receptors and endothelin-converting enzymes are expressed in the rat cochlea and that the serum endothelin levels in patients with sudden sensorineural hearing loss (SSHL) were significantly increased before steroid treatment. Since one subgroup of SSHL is believed to arise from vasoconstriction and vasospasm of the spiral modiolar artery ultimately causing ischemic stroke of the cochlea, we conducted a clinical investigation of fasudil (Rho-kinase inhibitor) combined with a steroid for the treatment of SSHL by preventing the inner ear ischemia induced by endothelin. Nine out of ten SSHL patients (90%) who received intravenous infusion of fasudil (9 days×30mg twice/day) showed complete or significant recovery in the level of hearing. The average hearing level was 72.7dB (n=10) before fasudil treatment, 44.9dB at the end of fasudil treatment (9 days after), and 31.9dB at the final evaluation. These results indicate that idiopathic SSHL could be caused by endothelin-induced vasoconstriction and vasospasm of the spiral modiolar artery of the cochlea, and that the fasudil administration combined with a steroid may be a novel potent treatment option for SSHL.

Journal

  • AUDIOLOGY JAPAN

    AUDIOLOGY JAPAN 50 (2), 144-149, 2007

    Japan Audiological Society

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