Overcoming barriers: a review on innovations in drug delivery to the middle and inner ear

Derek S Delaney; Lawrence J Liew; Joey Lye; Marcus D Atlas; Elaine Y M Wong

doi:10.3389/fphar.2023.1207141

Overcoming barriers: a review on innovations in drug delivery to the middle and inner ear

Front Pharmacol. 2023 Oct 19:14:1207141. doi: 10.3389/fphar.2023.1207141. eCollection 2023.

Authors

Derek S Delaney^#^{1

2}, Lawrence J Liew^#^{1

3}, Joey Lye¹, Marcus D Atlas^{1

3

4}, Elaine Y M Wong^{1

3

4}

Affiliations

¹ Hearing Therapeutics, Ear Science Institute Australia, Nedlands, WA, Australia.
² Faculty of Health Sciences, Curtin Health Innovation Research Institute, Curtin University, Bentley, WA, Australia.
³ Centre for Ear Sciences, Medical School, The University of Western Australia, Nedlands, WA, Australia.
⁴ Faculty of Health Sciences, Curtin Medical School, Curtin University, Bentley, WA, Australia.

^# Contributed equally.

Abstract

Despite significant advances in the development of therapeutics for hearing loss, drug delivery to the middle and inner ear remains a challenge. As conventional oral or intravascular administration are ineffective due to poor bioavailability and impermeability of the blood-labyrinth-barrier, localized delivery is becoming a preferable approach for certain drugs. Even then, localized delivery to the ear precludes continual drug delivery due to the invasive and potentially traumatic procedures required to access the middle and inner ear. To address this, the preclinical development of controlled release therapeutics and drug delivery devices have greatly advanced, with some now showing promise clinically. This review will discuss the existing challenges in drug development for treating the most prevalent and damaging hearing disorders, in particular otitis media, perforation of the tympanic membrane, cholesteatoma and sensorineural hearing loss. We will then address novel developments in drug delivery that address these including novel controlled release therapeutics such as hydrogel and nanotechnology and finally, novel device delivery approaches such as microfluidic systems and cochlear prosthesis-mediated delivery. The aim of this review is to investigate how drugs can reach the middle and inner ear more efficiently and how recent innovations could be applied in aiding drug delivery in certain pathologic contexts.

Keywords: biomaterials; drug delivery; hydrogel; inner ear; microdevices; middle ear; nanoparticle.

Publication types

Review

Grants and funding

This research is supported by the Australian government National Health and Medical Research Council (NHMRC) Medical Research Future Fund (MRFF) Stem Cell Therapies Mission Grant, Western Australian (WA) Future Health Research and Innovation Fund (FHRIF) Near-miss Awards: Ideas Grants (WANMA), Commonwealth Scientific and Industrial Research Organisation (CSIRO) ON Prime Innovation Program, Passe and Williams Foundation, Stan Perron Charitable Foundation and Channel 7 Telethon Trust and and WA Department of Jobs, Tourism, Science and Innovative (JTSI) Industries Fund 2023 Innovation Booster Grant.