Obstacles in the treatment of inner ear illnesses include the exact delivery of medication molecules to sick cells. Systemic therapy, the initial line of treatment, typically results in sub-optimal inner ear medication concentration because of the blood-labyrinth barrier (BLB). Even while the concentration of the medicine in the inner ear may be higher using the currently recommended local drug delivery techniques, such as intratympanic and intracochlear administration, drainage through the Eustachian tube is difficult. The search for better local delivery systems for inner ear therapy has been spurred by the unfavourable need for numerous doses to maintain therapeutic levels of the substance.

Currently, intratympanic injection, systemic medication administration, and surgical intervention are used to treat inner ear problems. Despite the wide range of available treatments, existing methods have been linked to variable efficacy and safety. Systemic therapy is a noninvasive treatment option that is frequently used to treat Ménière's disease and sudden sensorineural hearing loss. However, it has been associated with subtherapeutic inner ear medication concentrations and side effects. Higher inner ear medication concentrations can be achieved through intratympanic injection, which entails injecting a drug into the middle ear and relies on diffusion into the inner ear. Intratympanic injection, however, has drawbacks including the potential to harm middle ear structures, variable inner ear drug diffusion rates, and unintended drug clearance via the eustachian tube.

An alternative technique that lessens intratympanic injection's unpredictability is direct microinjection of medications through a cochleostomy, however doing so involves a risk of severe inner ear damage. Therefore, there is an unmet demand for novel, secure, and efficient inner ear delivery techniques. The anatomic obstacles built into the bone labyrinth are the main cause of the difficulties with current therapeutic approaches. Therefore, recent improvements in medication delivery methods have concentrated on getting over these obstacles. This review's objective is to examine recent developments in inner ear drug delivery methods within the context of anatomical barriers.

The inner ear's vascular compartment and fluid spaces are separated by the BLB. The BLB is made up of a network of vascular endothelial cells connected by tight junctions, basement membrane, pericytes, and resident macrophage-like melanocytes in the perivascular space, which together control blood flow via the perivascular space. The BLB also prevents therapeutic medications in systemic circulation from accessing the inner ear in addition to maintaining normal fluid and ion physiology and keeping pathogens from getting inside. According to estimates, the BLB restricts diffusion to 6.5% and 3.7% of total plasma concentration in the scala tympani and scala vestibuli perilymph, respectively.

Journal of Clinical Nephrology and Therapeutics is an open access, peer reviewed journal committed to publishing articles on all aspects of the advances in clinical research in Nephrology, Diabetic nephropathy, Pediatric nephrology, Renal physiology, Transplant medicine, Immunosuppression management, Intensive care nephrology, Ischemic nephropathy, Perioperative medicine etc.

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