The Effect of Hydrogen Peroxide Applied to the Middle Ear on Inner Ear Function

Objectives/Hypothesis: The objective was to assess the effect of hydrogen peroxide applied to the middle ear on cochlear and vestibular function. Study Design: Prospective animal study. Methods: Sand rats underwent a right-side total labyrinthectomy, and a polyethylene tube was inserted into the left-side middle ear. Following baseline recordings of vestibular evoked potentials in response to linear acceleration stimuli and auditory brainstem response, each experimental animal received five daily applications of hydrogen peroxide into the left-side middle ear. Two control groups received saline and gentamicin, respectively. Subsequently, recordings were repeated and compared with baseline measurements. Results: Saline administration affected neither vestibular evoked potentials nor auditory brainstem response. In contrast, both responses could not be recorded following gentamicin application. After hydrogen peroxide administration, auditory brainstem response could not be recorded in 25% (3 of 12) of the animals, whereas in the remaining nine animals the average auditory brainstem response threshold was significantly elevated by 55 dB (P = .000002). Linear vestibular evoked potentials could not be recorded in 42% (5 of 12) of the animals. Conclusion: It appears that topical hydrogen peroxide adversely affects both cochlear and vestibular function of the sand rat. The study demonstrated the effect of a reactive oxygen species on inner ear function and may be useful in the study of mechanisms responsible for this damage and its protection. Clinically, although an animal model was used in the present study, caution should be exercised when large amounts of hydrogen peroxide are applied to a dry, perforated ear.