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DOI: 10.1055/s-0041-1728400
Hearing preservation after intracochlear steroid injection using a cochlea-catheter directly before cochlea-implantation
Preservation of structure and residual hearing are among the most important challenges of today's and future cochlear implantation. In addition to atraumatic electrodes and an optimized surgical technique, there are also pharmacological approaches to achieve these goals. Problems of local application are the variable permeability of the round window membrane and the low diffusion within the cochlea. Special drug delivery procedures are needed to enable pharmacotherapy in apical regions and to preserve the low frequency residual hearing in the future. The application of a drug also in more apical regions can be achieved safely with a cochlear catheter.
In order to investigate the effect of a steroid application on residual hearing, 10 patients with Titel:residual hearing that did not meet the criteria for electro-acoustic-stimulation were treated with a steroid injection via the catheter and subsequent insertion of a Med-El Flex28 electrode. Cochlear microphonics were measured intraoperatively and auditory thresholds were measured pre- and postoperatively. The hearing preservation was compared to that of patients who received no intracochlear steroid application but the same electrode.
In the intraoperative CM measurements, at best, discreet decline of the thresholds was seen during the catheter application. Postoperatively, hearing loss was at least similar to the controls.
In summary, the application of triamcinolone with of a cochlear catheter is an atraumatic procedure, with which even residual hearing can be protected. This mode of administration is thus also of interest for other applications such as any pharmacological, genetic or cell-based therapies of the cochlea.
Poster-PDF A-1429.pdf
Cluster of Excellence Hearing4All, Med-El
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Conflict of interest
The first author points out the following conflict of interest: Übernahme von Kongress- und Reisekosten durch die Firma Med-El.
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Artikel online veröffentlicht:
13. Mai 2021
© 2021. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).
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