Preventing Internal Auditory Artery Vasospasm Using Topical Papaverine: An Animal Study

Krzysztof Morawski, Fred F. Telischi, Faisal Merchant, Grzegorz Namyslowski, Grazyna Lisowska, Brenda L. Lonsbury-Martin

Research output: Contribution to journalArticle

19 Scopus citations

Abstract

Background: Internal auditory artery (IAA) spasm is thought to be one of the causes of postoperative sensory hearing loss after attempted hearing preservation removal of an acoustic neuroma. The use of topical papaverine, a nonspecific vasodilator, to prevent vascular insufficiency to the inner ear and to improve hearing outcomes has been suggested but not proven. Materials and Methods: Vasospasm was mechanically induced by compressing the IAA in the control ears of six rabbits after application of topical saline. The subsequent reduction of cochlear blood flow (CBF) was measured using a laser-Doppler (LD) flow-monitoring technique. Functional loss of cochlear activity was verified with distortion product otoacoustic emissions (DPOAE). The contralateral experimental ears were treated with the topical application of papaverine directly to the IAA and cochleovestibular nerve complex. CBF and DPOAE were compared between the control and papaverine treated ears for 3-minute and 5-minute IAA compressions. Results: Every control ear demonstrated some degree of post-compression IAA vasospasm (i.e., reduced CBF) and reduction of DPOAE. Nearly complete recovery of CBF and DPOAE to baseline was observed in all of the papaverine treated ears. Conclusions: An animal model of IAA vasospasm was described. Mechanically induced vasospasm of the IAA was prevented by the topical application of papaverine. These findings have clinical implications for surgical procedures involving the internal auditory canal/cerebellopontine angle such as acoustic neuroma removal.

Original languageEnglish (US)
Pages (from-to)918-926
Number of pages9
JournalOtology and Neurotology
Volume24
Issue number6
DOIs
StatePublished - Nov 1 2003

Keywords

  • Acoustic neuroma
  • Distortion product otoacoustic emissions
  • Internal auditory artery
  • Papaverine
  • Rabbit
  • Vasospasm

ASJC Scopus subject areas

  • Otorhinolaryngology
  • Neuroscience(all)

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