sodium salicylnt.e, yet the full effect on auditory .... increase of salicylat.e concentration in. PL was as ..... Josef E. Fischer, MD (Arch Surp 1986:l2.l:l(KO-I047).
Differential Uptake of Salicylate Serum, Cerebrospinal Fluid, and
•
III
Peril~mph
PlLwel J. Jastrebolf, PhD; Roiemll'ie HilJlIe.D; Pelf:( G. Sasaki: Clarenee T. Sasaki, IdD
•
• Allar Inllapllllo"'I.1 ,clmlnl,II.lIon 0 1 "lIellaleln Inl.U... tlzld rl"lnd Quln· I. plga, WI lound Iha' 1.lIey'a'l 1..... 1. In· p.rllympn (Pl) .,. CIO•• ly II'at.d to both dIu", IIWII, In cerebralplnal lIuld (CSF) &"CI In ,.,um, with hlghlr '1 ...111 I.,al,mal· lutly ob .. ' .... d In PL Il'Iln In CSF. Further Inal.,a" IUIIIII,la Ihlt saUeylll1 " not p ...lwl'Y Iranlporled Into PLaclo.. CSF but. rather. II trln.po rlld hom blood direclly to PL. Tne tim. course 01 •• lIey· I,tl uptake In ,atl ,."."1 muimum taw'
, ' I .t II't hOUI. (.. ,urn) Ind two to lour hour, (C5F and PLIo On tM o lhe, hInd, .alleyla ll uptake 11'1 10 .ll um and CSF 01 lIul"l' plgl Ixhlbl t' a longlr lime coulle. wllh maxim um levell le.ched al lout houlS (Illrum) and live hOU II (CSF). Theil da la. nol pl.vlousl., avallabla. ara bllic 10 our utlde"landlng 01 .allcylate-I.laled audllof~ .lIectl. (A rch Olol"'Jiflgol H.,d Hecll. Sur" 1986; 112: 1050.1053)
Aspirin, acetylsalicylic acid. is the most widely employed antiinflammatory. antipyretic-analgesic drug today. Willow bark (Salix alOO), known to the :Lncients for its antipyretic properties. yielded salicifl., a bitter glycoside first discovered by
.1"1.
•
AeupltCl fnl publlcal ion March 18, 1980. From Ibl Dtplrtmtnt nf Slitif r)'. Section of OtnllrynllOi(llO". YII. Uninnity &hool of Mellicin.. NUl' Ilavtn. Coan. • Rfpnnt rt(JIIQt.I tG Department nf S!i11'1")', ~tl nn of OlGl • .,'lI1f010i)·. Ylle Uninfllry Scbf)QI of ~Itdic'ne. 333 c.dat 51. New n,~,"n. CT OMIO !Dr Jutr,boll ).
1050
concentrations of 1 to 2 mm.u they Leroux in 1827} Since then, synthetic may directly interfere with the salicylates, including sodium salicyenergy-demandinll functions of hair late, phenyl salicylate, and acetylsalicells as well. While the metabolism of cylic acid, gradually replaced the salicylate is generally well undermore expensive. naturally occurring stood,lUOl nevertheless, iLS pharma· compound. However, despite the procokinetics with respect to auditory duction of se.\·eral newer agents, aspifunction have yet to be systematically rin remains the cornerstone of theradescribed. py today and the drug of choice in the Mitchell et al' observed that serum treatment of rheumatoid arthritis, for concentration of salicylate increased which doses of nearly 5 to 6 g daily are rapidly followin g injection of very advised. In practice, individually recsodium salicylnt.e, yet the full effect ommended doses are predominantly on auditory action potentials was limited by the onset of tinnitus.'" Due delayed by a few hours. Similar delays to the reliability oC aspirin-induced had been observed by other investigatinnitus,' this symptom is now used as indicating differential uptake tors,,,.11 an indicator of maximum doses allowof drug into the relevant. body Huids. able for patienu with normal hearThese findings made it difficult to ing.' Higher doses systematieally directly relate the serum salicylate cause a loss of hearing, a loss that is level to its auditory action. Although completely reversible two to three other investigators' analyzed salicydays after drull withdrawal.'"" late in serum, cerebrospinal fluid There is general consensus that (CSF), and perilymph (PL) of cau. salicylate induces its effect on the showi ng an average salicylate level of auditory system at the level oC the 25 mg/ dL (1.81mM ) in PL after three cochlea..... " In addition to its wellto four hours, they lacked specific known interaction with synthesis or data concerning the time course of prostaglandins.')." salicylate has been salicylate uptake into PL. Furthershown to significantly decrease serum more, the fact that some samples were calcium !eve!s'J.ll and to interfere with collected postmortem made it addimembrane ien transporl.'Wl tionally difficult to hypothesize on the Furthermore, since salicylates have basis of those data. been shown to enter mitochondria"" The precise mechanism of salicylate and completely abolish aerobic syntransport into PL remains unknown . thesis of adenosine triphosphate :It
Ar c h OlolllrYr"lgol Head Neck Surg-Vol 112. Oel 1986
SlIllcyl'Ue-JlIstfllbo" fit .1
•
!
eo ('.3
