System and method for delivery of a therapeutic agent to the inner ear
Embodiments of the invention provide systems and methods for delivering therapeutic compositions to the inner-ear to treat inner-ear disorders. An embodiment of such a system comprises a sheath for insertion into the auditory canal and a cannula which can be inserted through the sheath. The cannula can include a tip for piercing the tympanic membrane and delivering the composition to an inner-ear tissue surface. The system may also include a therapeutic composition comprising a therapeutic agent and a thixotropic material which allows the composition to be delivered (e.g., by injection) through the cannula in liquid form and transition to gel-form once delivered to the tissue surface. A method for using the system comprises introducing the sheath into the ear, introducing the cannula through the sheath to pierce the tympanic membrane and position the tip adjacent an inner-ear tissue surface; and delivering the composition through the cannula to adhere to the tissue surface.
1. A method for treating a disorder of the inner ear of a patient using a therapeutic composition comprising a therapeutic agent, the method comprising:
introducing a delivery sheath through the auditory canal to be positioned adjacent to the tympanic membrane;
introducing a cannula through the delivery sheath to pierce the tympanic membrane and then be advanced to position a distal end of the cannula adjacent a tissue surface comprising the round window membrane, the composition configured to adhere to the tissue surface of the round window membrane for an extended period of time;
delivering a single drop of a therapeutically effective amount of the therapeutic composition through the cannula to the tissue surface such that the composition adheres to the tissue surface for the extended period of time, the single drop of the therapeutic composition having a drop size which does not significantly affect the function of the round window such that the patient's hearing is not reduced by more than 10%;
wherein the drop has a major diameter measured when placed on the round window which is equal or less than about 1.25 mm, and wherein the drop size of therapeutic agent is measured using a gauge positioned on a distal portion of the cannula, the gauge being visible under a medical imaging modality; and
delivering the therapeutic agent from the therapeutic composition on the tissue surface to the inner ear.
2. The method of claim 1 , wherein the therapeutic agent is configured to diffuse through the tissue surface to deliver the therapeutic agent to the inner ear.
3. The method of claim 2 , wherein the therapeutic agent diffuses through the tissue surface to provide for a long term release of therapeutic agent to the inner ear.
4. The method of claim 3 , wherein the long term release of therapeutic agent occurs over a period up to about 24 hours.
5. The method of claim 3 , wherein the long term release of therapeutic agent occurs over a period up to about 96 hours.
6. The method of claim 1 wherein the major diameter of the drop is equal or less than about 0.63 mm.
7. The method of claim 1 , wherein the drop size of therapeutic agent is controlled using a rheological property of the therapeutic composition including at least one of viscosity or surface tension of the composition.
8. The method of claim 1 , wherein the therapeutic composition comprises a thixotropic material which allows the therapeutic composition to be delivered through the cannula in a liquid form and then convert to a gel form when delivered to the tissue surface.
9. The method of claim 8 , wherein the therapeutic composition comprises at least one of PLA, PLGA, a PLA/PLGA blend or collagen.
10. The method of claim 1 , wherein the therapeutic composition comprises a corticosteroid.
11. The method of claim 10 , wherein the corticosteroid is delivered to treat noise induced treat hearing loss.
12. The method of claim 10 , wherein the therapeutic composition comprises dexamethasone.
13. The method of claim 10 , wherein the therapeutic composition comprises methylprednisone.
14. The method of claim 1 , wherein the therapeutic composition comprises an antioxidant.
15. The method of claim 14 , wherein the antioxidant is delivered to treat cisplatin ototoxicity.
16. The method of claim 14 , wherein the antioxidant is selected from the group consisting of D-methionine, N-acetylcysteine, and thiourea.
17. The method of claim 1 , wherein the therapeutic composition comprises a growth factor or nerve growth factor.
18. The method of claim 1 , wherein the therapeutic composition comprises an immune-suppressant agent.
19. The method of claim 1 , wherein the extended period of time is from about 4 hours to 14 days.
20. A method for treating a disorder of the inner ear of a patient using a therapeutic composition comprising a therapeutic agent, the method comprising:
introducing a delivery sheath through the auditory canal to be positioned adjacent to the tympanic membrane;
introducing a cannula through the delivery sheath to pierce the tympanic membrane and then be advanced to position a distal end of the cannula adjacent a tissue surface in or near the round window to allow the therapeutic composition to be delivered to a surface on the round window, the composition configured to adhere to the tissue surface for an extended period of time;
delivering a therapeutically effective amount of the therapeutic composition through the cannula to the tissue surface such that the composition adheres to the tissue surface for the extended period of time, the delivered amount of therapeutic agent comprising a drop of the therapeutic composition having a drop size which does not significantly affect the function of the round window such that patient's hearing is not reduced by more than 10%,
wherein the drop has a major diameter measured when placed on the round window which is equal or less than about 1.25 mm, and wherein the drop size of therapeutic agent is measured using a gauge positioned on a distal portion of the cannula, the gauge being visible under a medical imaging modality; and
delivering the therapeutic agent from the therapeutic composition on the tissue surface on the round window to the inner ear.
21. A method for treating a disorder of the inner ear of a patient using a therapeutic composition comprising a therapeutic agent, the method comprising:
introducing a delivery sheath through the auditory canal to be positioned adjacent to the tympanic membrane;
introducing a cannula through the delivery sheath to pierce the tympanic membrane, the cannula having a gauge positioned on a distal portion of the cannula, the gauge configured to measure a drop size of a therapeutic composition delivered from the cannula tip to a tissue surface on the inner ear;
advancing the cannula to position a distal end of the cannula adjacent a tissue surface in or near the round window to allow the therapeutic composition to be delivered to a surface on the round window; the composition configured to adhere to the tissue surface for an extended period of time;
delivering a single drop of a therapeutically effective amount of the therapeutic composition through the cannula to the tissue surface, said single drop having a size selected to adhere to the tissue surface for the extended period of time; wherein the gauge is used to control a drop size of the therapeutic composition delivered to the tissue surface;
wherein the drop has a major diameter measured when placed on the round window which is equal or less than about 1.25 mm, and wherein the drop size of therapeutic agent is measured using a gauge positioned on a distal portion of the cannula, the gauge being visible under a medical imaging modality; and
delivering the therapeutic agent from the therapeutic composition on the tissue surface on or adjacent the round window to the inner ear.
22. A method for treating a disorder of the inner ear of a patient using a therapeutic composition comprising a therapeutic agent, the method comprising:
introducing a delivery sheath through the auditory canal to be positioned adjacent to the tympanic membrane;
introducing a cannula through the delivery sheath to pierce the tympanic membrane and then be advanced to position a distal end of the cannula adjacent a tissue surface to allow the therapeutic composition to be delivered to the tissue surface, the tissue surface being on the round window, the composition configured to adhere to the tissue surface of the inner ear for an extended period of time;
delivering a single drop of a therapeutically effective amount of the therapeutic composition through the cannula to the tissue surface such that the composition adheres to the tissue surface for the extended period of time, the delivered amount of therapeutic agent having a drop size which does not significantly affect the function of the round window such that the patient's hearing is not reduced by more than 10%;
wherein the drop has a major diameter measured when placed on the round window which is equal or less than about 1.25 mm, and wherein the drop size of therapeutic agent is measured using a gauge positioned on a distal portion of the cannula, the gauge being visible under a medical imaging modality;
delivering the therapeutic agent from the therapeutic composition on the tissue surface to the inner ear; and
wherein the therapeutic composition antioxidant is delivered to treat cisplatin ototoxicity.