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

Published online by Cambridge University Press:  08 March 2006

S P Thomas
Affiliation:
the Department of Otolaryngology, Poole Hospital NHS Trust, Poole, Dorset, UK.
J R Buckland
Affiliation:
the Department of Otolaryngology, Poole Hospital NHS Trust, Poole, Dorset, UK.
S R Rhys-Williams
Affiliation:
the Department of Otolaryngology, Poole Hospital NHS Trust, Poole, Dorset, UK.
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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.

Type
Book Review
Copyright
© 2005 Royal Society of Medicine Press

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