Introduction
Otomycosis is an infection of the external auditory canal caused by a
fungus commonly observed in the general otology clinic. It has a global
prevalence of 9% to 30% among patients with otalgia and otorrhea
symptoms [1]. The occurrence of otomycosis differs according to
various climatic factors, with higher prevalence in tropical and
subtropical regions, where it is warm and humid. The most prevalent
pathogenic fungi isolated in otomycosis are Aspergillus niger andCandida albicans. There is currently no standardized medication
regimen for otomycosis that offers novel therapeutic choices, including
herbal medication [2].
According to the World Health Organization, herbal plants are one of
the ideal sources for obtaining a range of medicines. Hence, these
plants should be studied further to discover their benefits, safety, and
effectiveness. Henna leaf (Lawsonia inermis) has long been valued for
its healing and medicinal properties since ancient times. The
therapeutic effects of various components of Henna are due to its
biologically active compound of 2-hydroxynapthoquinone (Lawsone)
[3]. Studies have shown that henna leaf extracts in Malaysia inhibit
the development of pathogenic fungi [4].
For centuries, henna leaves have been used in Africa, the Middle East,
and Asian countries due to their healing attributes, such as antifungal,
antibacterial, anti-amoebiasis, and antihemorrhagic effects [5].
This is via the action of its phytoconstituents β-sitosterol glucoside,
flavonoids, quinoids, naphthalene derivatives, luteolin, betulin, lupeol
galic acid, coumarins, xanthones, and phenolic glycosides [6]. Every
part of the henna tree has been studied and found to have antifungal and
antitubercular activity [7], while the bark has been found to show
anti-inflammatory activity [8]. While its capacity to inhibit the
growth of pathogenic fungi causing otomycosis has been well established
[4, 5, 7, 9], this medicinal plant’s ototoxicity status is still
unknown. Ototoxicity is defined as cellular and functional impairment of
the inner ear by therapeutic agents and can be classified into
cochleotoxic and vestibulotoxic [10].
This study aims to determine the vestibulotoxic effect of the henna
extract with the possibility of developing it as an antifungal
preparation in otomycosis. Balance disruptions as a drug-side effect are
frequently overlooked by doctors, whereas patients often see it as part
of their condition and affecting their overall health. Most drug-induced
ototoxicity findings in patients are only restricted to the cochleotoxic
effect. However, studies of the vestibulotoxic effect are scarce. This
is a pilot project to evaluate the ototoxic effects of the henna extract
by analyzing specifically the vestibulotoxicity in a rat animal model.
To date, there is only one study assessing the vestibular side effects
of neem leaf extract in an animal study [10].