Potential ototoxicity from triamcinolone, neomycin, gramicidin and nystatin (Tri-Adcortyl) cream.

Abstract

Although rare, ototoxicity from the use of aminoglycoside drops is well recognized. Ototoxicity has not been described with the use of combination aminoglycoside-steroid-antifungal creams or ointments. We present the case of a 60-year-old man with a perforated tympanic membrane who suffered a total hearing loss after the instillation of cream containing triamcinolone, neomycin, gramicidin and nystatin (Tri-Adcortyl cream) into his ear canal. On balance, we believe that a number of potentially ototoxic constituents in this cream were responsible. Other possible causes of sensorineural hearing loss and the possible mechanisms of ototoxicity of this cream are discussed. The reasons why such creams may be particularly ototoxic, compared with drops, are also considered. The authors caution against the use of such creams or ointments in the ear if there is any suspicion of a tympanic membrane perforation.

• Authors: S P Thomas, J R Buckland, S R Rhys-Williams
• Journal: The Journal of laryngology and otology (J Laryngol Otol) Vol. 119 Issue 1 Pg. 48-50 (Jan 2005) ISSN: 0022-2151 [Print] England
• PMID: 15807966 (Publication Type: Case Reports, Journal Article)

Chemical References

• Anti-Bacterial Agents
• Anti-Inflammatory Agents
• Drug Combinations
• Gramicidin, Neomycin Sulfate, Nystatin, Triamcinolone Acetonide Drug Combination
• Nystatin
• Gramicidin
• Triamcinolone Acetonide
• Neomycin

Topics

• Administration, Topical
• Anti-Bacterial Agents (adverse effects)
• Anti-Inflammatory Agents (adverse effects)
• Deafness (chemically induced)
• Drug Combinations
• Drug Therapy, Combination (adverse effects)
• Gramicidin (adverse effects)
• Humans
• Male
• Middle Aged
• Neomycin (adverse effects)
• Nystatin (adverse effects)
• Triamcinolone Acetonide (adverse effects)
• Tympanic Membrane Perforation (drug therapy)