This work had as aim the evaluation of the central and peripheral hearing system of the subjects exposed to fuels. It was a prospective study, where attendants of three gas stations from Santa Maria were evaluated. After the adaptation to the inclusion criteria, the sample was composed of 24 subjects. A control group, of 24 was used in order to compare the results. The applied examinations were: Pure Tone Audiometry (PTA), Impedance Audiometry, research on acoustic reflexes, audiometry of high frequencies and the Auditory Brain Response (ABR). The average threshold of the study group was superior to the control group. The same occurred to the average thershold of the audiometry of high frequencies, in the range 9 to 14 kHz. In the frequencies from 16 to 20 kHz, the occurence of absent responses was higher in the study group in both ears. When compare in relation to the time of exposition, the average thresholds in high frequencies (9-14kHz) had significant statistical difference (p <0.05) in all the frequencies (9-14 kHz), when compared the control group to the study group. It was observed a greater absence of ipsilateral and contralateral acoustic reflexes in the right ear. In the left ear, there was no difference between the groups, concerning the occurrence of the ipsilateral reflex. The absence of contralateral reflex was bigger in the study group in all the teste frequencies. In the ABR, there was a change in the absolute latencies of Waves I and III and in all the interpeak latencies, in the right ear. In the left ear there was a change in the absolute latency of all the waves, and in all the interpeaks. The absolute latency of Wave III had greater occurrence of change, in both ears. The interaural difference of Wave V had a change in 19% of the subjects. The group exposed to fuels for at least three years demonstrated a change in the III-V interpeak of the right ear and in the absolute latency of Wave V in the left ear. In the group exposed for more than five years, the number of subjects with a change was statistical significant in: I-V interpeak of the right ear; absolute latency of Wave I and interpeak III-V of the left ear. It was verified that the subjects exposed to fuels had a statistically significant change in the average hearing thresholds in the frequencies 0.5 kHz (p=0.004), 2 kHz (p=0.001), 3 kHz (p=0.025), 9 kHz (p=0.007) and 10 kHz (p=0.026). In the ABR, it was observed a significant statistical difference in the interpeak III-V of the right ear (p=0.027) and the absolute latency of Wave V in the left ear (p=0.0257), in the group exposed for at least three years. In the group exposed for more than five years it was statistically significant the number of subjects with change in the I-V interpeak of the right ear (p=0.0173), in the absolute latency of Wave I and in the III-V interpeak of the left ear ( p=0.0173). / O presente trabalho teve como objetivo avaliar o sistema auditivo periférico e central de frentistas. Trata-se de um estudo prospectivo, onde foram avaliados frentistas de três postos de gasolina da cidade de Santa Maria. Após a adequação dos critérios de inclusão, a amostra totalizou 24 sujeitos. Um grupo controle, composto por 24 sujeitos, foi utilizado para comparação dos resultados. Os exames aplicados foram: audiometria tonal liminar (ATL), imitanciometria, audiometria de altas frequências e potenciais evocados auditivos de tronco encefálico (PEATE). A média de limiar na audiometria tonal liminar do grupo estudo foi superior a do grupo controle. O mesmo ocorreu com a média de limiar da audiometria de altas frequências, na faixa de 9 a 14kHz. Nas frequências de 16 a 20kHz, a ocorrência de respostas ausentes foi maior no grupo estudo em ambas as orelhas. Quando comparadas em relação ao tempo de exposição, as médias de limiares em altas frequências (9-14kHz) mostraram diferença estatisticamente (p<0,05) significante em todas as frequências (9-14kHz), quando comparados o grupo controle e o grupo estudo. Observou-se maior ausência de reflexos acústicos ipsi e contralateral no grupo estudo, na orelha direita. Na orelha esquerda, não houve diferença entre os grupos, quanto à ocorrência do reflexo ipsilateral. A ausência de reflexo contralateral foi maior no grupo estudo em todas as frequências testadas. No PEATE, houve alteração nas latências absolutas das ondas I e III e em todas as latências interpicos, na orelha direita. Na orelha esquerda houve alteração na latência absoluta de todas as ondas, e em todos os intervalos interpicos. A latência absoluta da onda III foi a que teve maior ocorrência de alteração, em ambas as orelhas. A diferença interaural da onda V mostrou alteração em 19% dos sujeitos. O grupo exposto a combustíveis há pelo menos três anos, apresentou alteração no intervalo interpico III-V da orelha direita e latência absoluta da onda V na orelha esquerda. No grupo exposto há mais de cinco anos, foram estatisticamente significantes o número de sujeitos com alteração: no intervalo interpico I-V da orelha direita; na latência absoluta da onda I e no intervalo interpico III-V da orelha esquerda. Verificou-se que frentistas apresentaram alteração estatisticamente significante nas médias de limiares auditivos nas frequências de 0,5 (p=0,004), 2 (p=0,001), 3 kHz (p=0,025),9kHz (p=0,007) e 10 kHz (p=0,026). No PEATE, observou-se diferença estatisticamente significante no intervalo interpico III-V da orelha direita (p=0,027) e na latência absoluta da onda V na orelha esquerda (p=0,0257), no grupo exposto por pelo menos três anos. No grupo exposto há mais de cinco anos foram estatisticamente significantes o número de sujeitos com alteração no intervalo interpico I-V da orelha direita (p=0,0173), na latência absoluta da onda I e no intervalo interpico III-V da orelha esquerda (p=0,0173).

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / The present work aims to investigate the cisplatin influence on the cochlea and the deoxiribonucleic acid (DNA) of guinea pigs. An experimental study was executed with 12 guinea pigs (Cavia porcellus). The inclusion criterion for guinea pigs in the sample was the presence of Preyer's reflex (contraction of the pinna when facing sound stimulus) and distortion product otoacoustic emissions (DPOAEs). Guinea pigs were divided into two groups: Control Group (CG) - composed by six guinea pigs, to which it was administrated physiological solution of sodium chloride 0.9% during six consecutive days; Study Group (SG) - composed by six guinea pigs to which it was administrated cisplatin in six consecutive doses of 3mg/kg/day intraperitoneally. Twenty-four hours after the last cisplatin injection, guinea pigs were sacrificed, the blood sample was collected to perform the Comet Essay, and the cochleas were removed to histological analysis. When comparing the SG guinea pigs before and after the cisplatin administration, it was verified a statistically significant reduction of the amplitude of DPOAEs, mainly in the frequencies of 1000Hz to 3998Hz. After the cisplatin administration, it was certified that the amplitude of the DPOAEs frequencies of 2830Hz and 5657Hz from the SG guinea pigs suffered a statistically significant reduction compared to the CG guinea pigs. After the Cisplatin administration there were not detected any identifiable DNA changes in the Comet essay, the histological analysis showed alterations in the organ of Corti and in the spiral ganglion. Cisplatin causes alterations in the function and cochlear morphology, however, any damage to the DNA was detected. / O presente trabalho tem como objetivo verificar a influência da cisplatina sobre a cóclea e o ácido desoxirribonucleico (DNA) de cobaias. Estudo experimental executado com 12 cobaias (Cavia porcellus). O critério de inclusão de cobaias na amostra foi a presença de reflexo de Preyer (contração do pavilhão auricular frente a estímulo sonoro) e emissões otoacústicas produto de distorção (EOAPDs). As cobaias foram dividas em dois grupos: Grupo controle (GC) - composto de seis cobaias, às quais foi administrada solução fisiológica de cloreto de sódio a 0,9% por seis dias consecutivos; Grupo estudo (GE) - composto por seis cobaias, às quais foi administrada cisplatina em seis doses consecutivas de 3mg/kg/dia via intraperitoneal. Vinte e quatro horas após a última aplicação de cisplatina as cobaias foram sacrificadas, foi coletada amostra sanguínea para realização do Ensaio Cometa, e as cócleas foram removidas para análise histológica. Ao comparar-se as cobaias do GE antes e após a administração de cisplatina verificou-se redução estatisticamente significante da amplitude das EOAPDs principalmente nas frequências de 1000Hz à 3998Hz. Após a administração de cisplatina constatou-se que a amplitude das EOAPDs nas frequências de 2830Hz e 5657Hz, das cobaias do GE, sofreram redução estatisticamente significante quando comparado com as cobaias do GC. Após a administração de cisplatina não foram detectados danos genotóxicos identificáveis no Ensaio Cometa, a análise histológica mostrou alterações no órgão de Corti e gânglio espiral. A cisplatina provoca alterações na função e morfologia coclear, no entanto não foi detectado dano genotóxico.

Two of the primary occupational health threats to employees in the mining industry are noise-induced hearing loss (NIHL) and occupational lung diseases (OLD) with Tuberculosis (TB) included in the latter. The objective of this study was to investigate the hearing profile of a group of gold miners with and without TB to determine the effect of TB and its associated risk profile on hearing. Workers in AngloGold Ashanti mine in South Africa were recruited due to the fact that they present with these two health threats namely NIHL and TB. The audiological and medical surveillance data of 2698 subjects (between the years 2001 and 2009) were used in analyses. Hearing thresholds for the air conduction frequencies (0.5, 1, 2, 3, 4, 6, 8 KHz) in both ears were analysed in conjunction with biographic and occupational data. Subjects were divided into three groups, two experimental groups (Single TB treatment, n= 911 and Multiple TB treatment, n= 376) and one control group (n= 1411). A highly significant difference (p<0.01) was noted between the control group and both TB treatment groups across most frequencies and hearing parameters analysed, although the higher frequencies were more affected. Pair wise comparisons revealed the largest differences in hearing thresholds throughout between the control group and the multiple TB treatment groups. The smallest differences in hearing thresholds were evident between the two TB groups with the multiple TB treatment group presenting with the poorest thresholds. TB and its related risk profile had a pronounced influence on the decline of hearing thresholds. Thresholds for the multiple TB treatment group indicated more deterioration than the hearing thresholds of the single TB treatment group. This may point to the possibility that the influence of repeated TB on the subjects’ hearing thresholds over time was more pronounced than a single incidence of TB. It is still necessary however to separate the effects of the disease from the effects of the treatment on hearing. / Dissertation (MCommunication Pathology)--University of Pretoria, 2012. / Speech-Language Pathology and Audiology / Unrestricted

Bacterial infections are a major cause of morbidity and mortality in both the community and nosocomial settings, particularly among the elderly and chronically ill. Sepsis is the body’s response to antigens and toxins released by the invasive pathogenic organisms that cause infection. When infection is not effectively controlled, sepsis may develop and progress to severe sepsis and septic shock. Early diagnosis and treatment is pivotal for survival in severe sepsis and particularly, septic shock. Our research focuses on developing a novel treatment strategy for septic shock by using single, ultra-high doses of aminoglycosides. In this project, the effect of a single, ultra-high dose of gentamicin in clearing bacteria from the blood and reducing the bacterial burden in vital organs was evaluated in a rat model of E. coli (Bort strain) induced peritonitis with severe sepsis/septic shock. Serum cytokine levels and serum lactate levels were serially measured. Further, the potential adverse effects of ultra-high dosing of aminoglycoside antibiotics in a short-term (9 h) invasive study and long term (180 days) non-invasive study were assessed. Neuromuscular paralyses due to ultra-high doses of aminoglycosides were assessed. In addition, renal injury markers such as serum creatinine and urinary Neutrophil Gelatinase Associated Lipocalin (NGAL) were assayed. The auditory and vestibular function was also assessed after ultra-high dosing of aminoglycoside in the long-term study. We conclude that animals can tolerate ultra-high doses of aminoglycosides with appropriate support. Animals were under neuromuscular paralysis for 28 – 50 minutes and were on ventilator support after single ultra-high doses (80 and 160 mg/kg) of aminoglycoside antibiotics (gentamicin and tobramycin). There was no significant acute or delayed renal or ototoxicity associated with the single, ultra-high dose aminoglycoside therapy. Histology studies of the kidneys and the cochlea of single, ultra-high aminoglycoside dosed animals and untreated control animals were performed after 180 days (6 months). Results indicated that there were no morphological differences between the treated and untreated control animals. Terminal deoxy-nucleotidyl transferase dUTP nick end labeling (TUNEL) assay of kidney tissue indicated that there was no apoptosis of endothelial cells in the tubular and glomerular regions with single, ultra- high dose of aminoglycosides consistent with an absence of ultrahigh dose induced nephrotoxicity. In the septic shock model, the E. coli Bort was below the limit of detection from the blood of the animals within minutes after single, ultra-high dose aminoglycoside administration. After necropsy, bacterial load was determined from all the vital organs and peritoneal fluid (site of infection). The bacterial levels were below the detection limit from the kidneys and there was a significant reduction in bacterial counts from all the remaining organs compared to the infected control animals. A decrease in serum cytokine and serum lactate levels compared to baseline was observed after ultra-high doses of aminoglycosides in the septic shock animals. Our studies have indicated that the ultra-high dose gentamicin is well tolerated by rats. It is highly effective in clearing E. coli Bort from the blood and reducing the bacterial burden in the organs in an experimental model of bacterial peritonitis/septic shock. Further studies in larger animals such as rabbits, sheep, pigs or dogs are required to confirm these results. If these findings are replicated in larger animals, this therapy may be developed further from ‘lab to bedside’ to treat septic shock patients in intensive care units (ICUs). / October 2015

Objectifs: Le Nystatin est un antibiotique efficace pour le traitement d’otomycose. Bien que sa sécurité au niveau de l’oreille externe soit bien établie, son utilisation n’est pas recommandée lorsqu’il y a une perforation tympanique. L’objectif de cette étude est d’évaluer le potentiel ototoxique du Nystatin lorsque celui-ci est appliqué directement au niveau de l’oreille moyenne. Méthodes: Nous avons fait une étude expérimentale avec 18 cochons d’Indes de souche Hartley que nous avons divisés en deux groupes. En exposant l’oreille moyenne de chaque animal au Nystatin (groupe I) ou à la néomycine (groupe II) et chaque oreille controlatérale à une solution physiologique (NaCl), la fonction auditive a été évaluée avec un test de potentiels évoqués auditif du tronc cérébral avant et après les injections. Une étude par microscopie électronique a permis une comparaison histologique de l’état des cellules ciliées cochléaires entre les 2 groupes. Résultats: Les pertes auditives moyennes du groupe « Nystatin » étaient de 13.0 dB et comparables aux pertes moyennes observées dans les oreilles ayant été injectées avec du NaCl (4.0 dB dans le groupe I et 15.1 dB dans le groupe II). Le groupe de contrôle « néomycine » a subi une perte auditive moyenne de 39.3 dB, ce qui représente une différence cliniquement et statistiquement significative (p<0.001). L’étude histologique avec une microscopie à balayage électronique a démontré une conservation de l’architecture des cellules ciliées cochléaires dans les groupe Nystatin et NaCl. La néomycine a causé une destruction marquée de ces structures. Conclusions: Le Nystatin ne provoque pas d’atteinte auditive ni de destruction des cellules ciliées externes après injection directe dans l’oreille moyenne chez le cochon d’Inde. / Objective: Nystatin is an effective topical antifungal agent widely used in the treatment of otomycosis. Though it is safe for external ear use, current recommendations are to avoid its use in cases of tympanic membrane perforation. The objective of our study was to test the security of Nystatin when applied directly to the middle ear of a guinea pig model. Methods: We performed an experimental study with 18 Hartley guinea pigs that were divided into two groups. Exposing middle ears from one group to Nystatin (group I) and from the other to the ototoxic neomycin (group II), we compared results of auditory brainstem response (ABR) testing at three intervals during the study. Each animal’s contralateral ear was injected with a physiological solution (NaCl). At the end of the study, we performed a histological analysis of the animals’ cochleae using a scanning electron microscope. Results: Average hearing loss in the Nystatin group was 13.0 dB which was similar to the results obtained in the NaCl-exposed ears (4.0 dB in group I and 15.1 dB in group II). Average hearing loss in the neomycin group was 39.3 dB, which represents a clinically significant difference (p<0.001). Scanning electron microscope evaluation revealed intact cochlear hair cell architecture in the Nystatin and normal saline groups, compared to important destruction in the neomycin group. Conclusion: Nystatin does not cause hearing impairment or cochlear hair cell damage when exposed directly to the middle ear of a guinea pig model.

INTRODUCTION: Le bleu de méthylène est un colorant grandement utilisé dans le domaine médical, notamment pour ses propriétés de coloration histologique. Il est également utilisé comme agent photosensibilisant dans la thérapie photodynamique antimicrobienne, qui une fois photoactivé devient efficace pour l’éradication de plusieurs germes multirésistants. L’objectif de cette étude est d’investiguer le potentiel ototoxique du bleu de méthylène. MÉTHODES: Vingt cochons d’Inde divisés en deux groupes, ont reçu une solution de bleu de méthylène et de gentamicine dans l’oreille testée. L’oreille controlatérale a reçu une solution saline contrôle. Nous avons procédés à des potentiels évoqués auditifs du tronc cérébral avant et une semaine suivant la série d’injections. À la suite des dissections, des analyses histologiques et immunohistochimiques ont été réalisées. RÉSULTATS: La différence moyenne de perte auditive dans le groupe gentamicine comparativement au groupe normal salin était de 66.25 dB (p<0.001). Toutefois, la différence moyenne de perte auditive dans le groupe ayant reçu du bleu de méthylène comparativement à celui ayant reçu des injections de la solution saline était de 1.50 dB, et n’a pas été démontré comme étant statistiquement significative (p=0.688). De plus, la captation de caspase-3 en immunohistochimie (marqueur d’apoptose) n’a pas été significative dans le groupe recevant le bleu de méthylène. CONCLUSION: À la lumière de nos résultats, les injections intratympaniques de bleu de méthylène n’ont pas démontrées de potentiel ototoxique. Nous recommandons des études supplémentaires afin d’en préciser son utilisation sécuritaire dans le domaine otologique. / INTRODUCTION: Methylene blue is widely used in the medical field, especially as a blue dye for staining. It is also used as a photosensitizing agent in antimicrobial photodynamic therapy, which once photoactivated is effective for the eradication of several multiresistant bacteria. The objective of this study is to investigate its ototoxic potential. METHODS: Twenty guinea pigs, forming two groups, received respectively intratympanic methylene blue and gentamicin in one ear. The contralateral ears received a control saline solution. We conducted auditory evoked brainstem response (ABR) before and one week after the injection series. Once completed, the cochleas were dissected and analyzed by histology and immunohistochemistry. RESULTS: The mean difference of hearing loss in the saline group compared to the gentamicin group was 66.25dB (p<0.001). However, the mean difference of hearing loss in the methylene blue group compared to normal saline was 1.50 dB, and it was not shown to be statistically significant (p=0.688). Furthermore, uptake of caspase-3 by immunohistochemistry (apoptotic marker) was negative in the group which received injections of methylene blue. CONCLUSION: In light of our results, intratympanic injections of methylene blue did not demonstrate an ototoxic potential. We recommend further studies to precise its usefulness in the otology field.

Au cours de ces années de Doctorat, nous avons étudié les effets ototoxiques de certains médicaments et les moyens de prévenir les surdités neuro-sensorielles quils peuvent induire. Parmi ces molécules, nous nous sommes concentrés sur les plus couramment utilisées en pratique clinique : les antibiotiques de la famille des aminoglycosides et le cisplatine, un agent anti-cancéreux. Lintroduction de notre travail replace la surdité dans son contexte de santé publique. En particulier, nous décrivons pourquoi les médicaments ototoxiques sont utilisés et dans quelles circonstances. Nous présentons la structure de loreille interne et nous tentons dexpliquer sa vulnérabilité aux molécules ototoxiques. Nous abordons ensuite les moyens de prévention et/ou de traitement de ces atteintes neuro-sensorielles pharmaco-induites. Outre les moyens classiques de prévention, que sont les facteurs trophiques et les antioxydants, nous décrivons de nouvelles voies dapproche que sont les voies de signalisation impliquant la protéine kinase C ou la cascade dactivation RhoA/ROCK. La présentation de notre travail original sarticule autour de deux parties. Dans la première partie, nous rapportons les résultats obtenus au cours de notre étude de la toxicité des aminoglycosides et du cisplatine chez la souris et le cobaye in vivo. Nous avons mis en évidence une différence de vulnérabilité significative entre ces deux espèces face à lagression ototoxique. Cette différence existe au niveau fonctionnel, mis en évidence par létude des potentiels évoqués auditifs, et au niveau anatomique, étudié en histologie et en immunohistochimie. Nous en discutons les implications en recherche et en pratique clinique. Dans la seconde partie, nous étudions les moyens de prévenir cette surdité in vivo et in vitro. Nous avons utilisé un modèle de surdité par aminoglycoside chez le cobaye. Nous avons testé et validé une technique de perfusion intra-cochléaire in vivo. Nous avons observé les effets de deux molécules expérimentales : la Bryostatine 1, un activateur de la protéine kinase C, et un inhibiteur de la voir RhoA-ROCK. Leffet protecteur de ces molécules est actuellement limité au ganglion spiral, dont la survie est essentielle à tout traitement dimplantation prothétique et de réadaptation. Nous discutons des perspectives en médecine humaine dans notre conclusion. In this work, we focused our attention on the effects of main ototoxic drugs i.e. aminoglycosides and cisplatin in mammals. We identified new avenues for the prevention of this toxicity. In the introduction, we described how and why ototoxic drugs are used. We then described potential otoprotective strategies in neurosensory deafness. Among them, trophic factors and antioxidant molecules have been widely used. New otoprotective approaches do exist, implying the protein kinase C or RhoA/ROCK signalling. Our original work was presented in two parts. In the first part, we reported the in vivo effects of aminoglycosides and cisplatin in two mammalian species: mice and guinea pigs. Contrarily to guinea pigs, evidence of mice resistance to ototoxicity was found at a functional level, assessed by auditory brainstem responses, and at an anatomical level, studied by immunohistochemistry. We discussed the implication of such differences in research and in clinical practice. In the second part, we studied the effect of two potential otoprotective molecules: Bryostatine 1, an activator of the protein kinase C, and Y-27632, a Rho kinase inhibitor. We showed that these molecules are protecting spiral ganglion neurons both in vitro and in vivo. Survival of spiral ganglion neurons is crucial in the management and rehabilitation of deafness. The potential perspectives of these results in human medicine were discussed.

Myringotomy plays an important role in otological therapy. The procedure requires an efficient anesthesia, which can be obtained without general anesthesia. However, the use of local anesthetics on the tympanic membrane (TM) has been abandoned in many places, as general anesthesia has been readily available. In the present study the effects of some commonly used topical anesthetics on the TM structure and inner ear were tested in an animal model (rat and guinea pig).Four different anesthetic compounds—Xylocaine®, Bonain's liquid, phenol and Emla®—were applied to the TMs of the animals, which were sacrificed 10 minutes to 5 months after application. Morphological effects regarding time after treatment and number of applications were elucidated. At sacrifice the tissue was fixed and the TMs analysed by light microscopy (LM) and transmission electron microscopy (TEM). In nine animals phenol, Xylocaine® Spray or Emla® was applied to the round window niche and ABR recordings were made at 24 h to 6 months after exposure. After the final ABR evaluation the animals were sacrificed and the cochleae prepared for LM and scanning electron microscopy (SEM).On the TM phenol and Bonain's liquid caused instant destruction of the keratinizing stratified squamous epithelium followed by long-lasting hyperplasia of this epithelium and the underlying connective tissue. A pronounced hyperplasia of these two layers was also noted for the Xylocaine® Spray group, but without immediate destruction of the keratinizing epithelium. The extent of structural changes differed in relation to the extent of spreading of the agent. Emla® showed little, if any, sign of epithelial reaction and had no effect on the connective tissue. Regarding the inner ear Emla®, Xylocaine® Spray and phenol induced significantly impaired ABR thresholds mainly affecting the higher frequencies. However, the impaired ABR thresholds were reversible and at the end of the experiment there was no significant impairment compared to the control data. All agents, except Xylocaine®, damaged the hair cells in the basal part of the cochlea as shown by cytocochleogram and SEM analysis.Instant destruction of the epidermis seems to be necessary for an instant anesthetic effect. All agents caused profound connective tissue reactions. The manner of application, depending on the physical properties of the agent, determined the extent of the structural changes. The changes of the connective tissue were concentrated to the submucosal layer, which seems to be the area for reconstruction of the damaged TM. All agents caused functional inner ear changes. With the exception of Xylocaine® they also caused morphological alterations of the cochlea. The functional changes were partly reversible. Topical anesthetics applied to the TM should be used with caution and when used in an appropriate manner they can be considered safe, especially in an inflamed middle ear, with a thickened round window membrane, which should prevent the agents from reaching the inner ear structures. / digitalisering@umu

Objectifs: Le Nystatin est un antibiotique efficace pour le traitement d’otomycose. Bien que sa sécurité au niveau de l’oreille externe soit bien établie, son utilisation n’est pas recommandée lorsqu’il y a une perforation tympanique. L’objectif de cette étude est d’évaluer le potentiel ototoxique du Nystatin lorsque celui-ci est appliqué directement au niveau de l’oreille moyenne. Méthodes: Nous avons fait une étude expérimentale avec 18 cochons d’Indes de souche Hartley que nous avons divisés en deux groupes. En exposant l’oreille moyenne de chaque animal au Nystatin (groupe I) ou à la néomycine (groupe II) et chaque oreille controlatérale à une solution physiologique (NaCl), la fonction auditive a été évaluée avec un test de potentiels évoqués auditif du tronc cérébral avant et après les injections. Une étude par microscopie électronique a permis une comparaison histologique de l’état des cellules ciliées cochléaires entre les 2 groupes. Résultats: Les pertes auditives moyennes du groupe « Nystatin » étaient de 13.0 dB et comparables aux pertes moyennes observées dans les oreilles ayant été injectées avec du NaCl (4.0 dB dans le groupe I et 15.1 dB dans le groupe II). Le groupe de contrôle « néomycine » a subi une perte auditive moyenne de 39.3 dB, ce qui représente une différence cliniquement et statistiquement significative (p<0.001). L’étude histologique avec une microscopie à balayage électronique a démontré une conservation de l’architecture des cellules ciliées cochléaires dans les groupe Nystatin et NaCl. La néomycine a causé une destruction marquée de ces structures. Conclusions: Le Nystatin ne provoque pas d’atteinte auditive ni de destruction des cellules ciliées externes après injection directe dans l’oreille moyenne chez le cochon d’Inde. / Objective: Nystatin is an effective topical antifungal agent widely used in the treatment of otomycosis. Though it is safe for external ear use, current recommendations are to avoid its use in cases of tympanic membrane perforation. The objective of our study was to test the security of Nystatin when applied directly to the middle ear of a guinea pig model. Methods: We performed an experimental study with 18 Hartley guinea pigs that were divided into two groups. Exposing middle ears from one group to Nystatin (group I) and from the other to the ototoxic neomycin (group II), we compared results of auditory brainstem response (ABR) testing at three intervals during the study. Each animal’s contralateral ear was injected with a physiological solution (NaCl). At the end of the study, we performed a histological analysis of the animals’ cochleae using a scanning electron microscope. Results: Average hearing loss in the Nystatin group was 13.0 dB which was similar to the results obtained in the NaCl-exposed ears (4.0 dB in group I and 15.1 dB in group II). Average hearing loss in the neomycin group was 39.3 dB, which represents a clinically significant difference (p<0.001). Scanning electron microscope evaluation revealed intact cochlear hair cell architecture in the Nystatin and normal saline groups, compared to important destruction in the neomycin group. Conclusion: Nystatin does not cause hearing impairment or cochlear hair cell damage when exposed directly to the middle ear of a guinea pig model.

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / The organophosphate pesticides are widely used in agriculture, and the widespread application of these agents, without the appropriate use of bio-security measures, has contributed to environmental degradation and the increased incidence of occupational poisoning, becoming one of the main public health problems in rural areas. Studies show that the ototoxic agents, in addition to the peripheral vestibular and auditory systems compromise, also impair central auditory pathways. Among the major toxic agents that can lead to hearing loss are the solvents, metals, suffocating and organophosphate pesticides. This study examined the acute ototoxic action of a pesticide on the peripheral auditory system. This is a prospective experimental study. We used male albino guinea pigs, divided into three groups, which was administered distilled water (group 1 - control), pesticide - 0.3 mg/Kg/day (group 2), pesticide - 3 mg/Kg/day (group 3), for seven consecutive days. The pesticide used was Tamaron® (methamidophos). The auditory functional evaluation was performed using the Distortion Product Otoacoustic Emissions (DPOAE) and Auditory Brainstem Response (ABR), both performed before and immediately after the application of the pesticide. The anatomical assessment was performed with scanning electron microscopy. The guinea pigs subjected to pesticide had cochlear morphological changes, with lesions in three turns examined in electron microscopy, which was increased according to the dosage received from the agent. In all animals the DPOAE was present, but it was verified that the signal/noise ratio of the frequencies of 1.500 and 6.000 Hz in DPOAE of groups 2 and 3 showed statistically significant difference when compared to control group, indicating possible cell impairment. There were no statistically significant changes in functional assessment of VIII nerve when evaluated by wave I of ABR. It is concluded that the organophosphorous can be considered as a harmful acute agent of outer hair cells, seen the correlation between the dose applied and the amount of changes observed by electron microscopy, however, the acute exposure to Tamaron® did not cause functional alteration of the peripheral auditory system. / Os agrotóxicos organofosforados são amplamente utilizados na agricultura, e a elevada aplicação desses agentes, sem o emprego das devidas medidas de biossegurança, vem contribuindo para a degradação ambiental e para o aumento da incidência de intoxicação ocupacional, tornando-se um dos principais problemas de saúde pública no meio rural. Pesquisas demonstram que os agentes ototóxicos, além de comprometer os sistemas auditivo e vestibular periféricos, provocam ainda alterações nas vias auditivas centrais. Dentre os principais agentes químicos que podem levar à perda auditiva incluem-se os solventes, os metais, os asfixiantes e os agrotóxicos organofosforados. O objetivo deste estudo foi analisar a ação ototóxica aguda de um agrotóxico do grupo dos organofosforados no sistema auditivo periférico. Trata-se de um estudo experimental prospectivo, realizado em cobaias albinas machos, divididas em três grupos, nos quais se administrou água destilada (grupo 1 - controle), agrotóxico - 0,3mg/Kg/dia (grupo 2), agrotóxico 3 mg/Kg/dia (grupo 3), durante sete dias consecutivos. O agrotóxico utilizado foi Tamaron® (metamidofós). A avaliação auditiva funcional foi realizada utilizando-se Emissões Otoacústicas Produto de Distorção (EOAPD) e Potencial Evocado Auditivo de Tronco Encefálico (PEATE), ambos realizados antes e imediatamente após o período de aplicação do agrotóxico. A avaliação anatômica foi realizada com Microscopia Eletrônica de Varredura. As cobaias submetidas ao agrotóxico apresentaram alterações morfológicas cocleares, com lesões nas três espiras analisadas na microscopia eletrônica, intensificadas de acordo com a dosagem recebida do agente. Na avaliação auditiva funcional, todas as cobaias apresentaram EOAPD presentes, no entanto verificou-se significância estatística nos valores da relação sinal/ruído das frequências de 1.500 e 6.000 Hz das EOAPD das cobaias dos grupos 2 e 3 quando confrontados com os achados dos animais do grupo controle, indicando um possível sofrimento celular. Não foram encontradas alterações estatisticamente significantes na avaliação do VIII par craniano por meio da análise da onda I do PEATE. Concluiu-se que o organofosforado pode ser considerado um agente lesivo agudo das células ciliadas externas visto a correlação entre a dosagem aplicada e a quantidade de alterações observadas à microscopia eletrônica, entretanto a exposição aguda ao Tamaron® não causou alteração funcional do sistema auditivo periférico.