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Table 2 Results for chlorhexidine and ethanol-based antiseptic preparations

From: Systematic review of ototoxic pre-surgical antiseptic preparations – what is the evidence?

Author, Year Population Intervention Control Outcomes
R. Perez, 2000 [10] 25 Sand Rats a) Solutions tested
Povidone-iodine 10% solution
b) Chlorhexidine Gluconate 0.5% solution
c) Ethyl alcohol in 70% aqueous solution
Exposure time 3 days
ABR and vestibular evoked potentials (VsEP) testing 8 days after initial exposure
a) Saline as negative control
b) Gentamycin as positive control
a) ABR not present after Chlorhexidine Gluconate 0.5% solution
b) ABR present at baseline after application of Povidone-iodine 10% solution, VsEP present in all test animals
c) No ABR or VsEP recorded in 2/5 animals after Ethyl alcohol 70% solution, 3/5 had elevated thresholds (70-80 dB)
d) Erythema and oedema noted in 5/5 middle ear cavities after application of ethyl alcohol
Y. Igarashi, 1985 [9] 12 Cats Solutions tested
a) Chlorhexidine Gluconate 2.0%
b) Chlorhexidine Gluconate 0.05%
Exposure time every 2 days × 3 applications. Histologic examination at 7 days and 4 weeks
Contralateral ear to the experimental ear a) Gross examination of middle ear space showed thick serous fluid retention in12/12 animals
b) Histological examination showed loss of outer hair less in lower cochlear turns, with 85% loss near the round window after application of Chlorhexidine gluconate 2% solutions
c) Little to no damage to the outer hair cells seen with Chlorhexidine 0.05% solution
J. Aursnes, 1981 [14] 48 Guinea Pigs Solutions tested
a) Chlorhexidine 0.1% in 70% alcohol
b) Chlorhexidine 0.1% in aqua. Solution
c) Chlorhexidine 0.5% in 70% alcohol
d) Chlorhexidine 0.5% in aqua. Solution
Exposure time 10, 30 and 60 mins. Histological examination done after 2, 3, 4 or 10 weeks post exposure
Contralateral ear to experimental ear a) Gross examination showed extensive fibrotic tissue after 60 min exposure time
b) Greater degree of fibrosis with 0.5% solution compared to 0.1% solution
c) Total destruction of outer hair cells seen 3 weeks after exposure with Chlorhexidine 0.5% in 70% alcohol
H. G. Galle, 1986 [18] 2 Guinea Pigs Solution tested
a) Savlon™* in 1:100 dilution
Cochlear microphonics, histologic examination and behaviour measured at 24 h and 48 h after exposure
* Composed of 1.5% Chlorhexidine Gluconate and 0.15% cetrimide (quaternary ammonium compound)
Contralateral ear to experimental ear a) Severe vestibular dysfunction based on behaviour but effects diminished after 24 h and again after 48 h
b) Hearing thresholds increased from baseline of 35 dB to 70 dB SPL
T. Morizono, 1981 [11] 23 Chinchillas Solutions tested
a) Ethanol in contractions of 0.1, 1, 3, 10, 25, 50, 70 and 100%
Exposure time was 10mins, 24 h. Cochlear mircophonics and endocochlear Action potentials tested
Contralateral ear to experimental ear a) Variable outcomes with some animals showing decrease in all frequencies tested with cochlear microphonics with 3% solutions while others showed no deficits with 50% solution