Dexamethasone Is One of the Factors Minimizing the Inner Ear Damage from Electrode Insertion in Cochlear Implantation

2016 ◽  
Vol 21 (3) ◽  
pp. 178-186 ◽  
Author(s):  
Hyun Soo Cho ◽  
Kyu-Yup Lee ◽  
Hongsoo Choi ◽  
Jeong Hun Jang ◽  
Sang Heun Lee
Keyword(s):  
Inner Ear ◽  
Cochlear Implantation ◽  
Hearing Threshold ◽  
Hearing Preservation ◽  
Control Group ◽  
Hearing Level ◽  
Hearing Thresholds ◽  
The Difference ◽  
Caloric Response ◽  
Inner Ear Damage

The aim of this study was to investigate the efficacy of preoperative and intraoperative steroid administration for inner ear protection in cochlear implantation (CI). Nineteen subjects who underwent CI were included in the study, and 10 subjects were enrolled as controls (steroid-administered group, n = 19; control group, n = 10). Dexamethasone (dexamethasone sodium phosphate, 5 mg/ml) was systemically administered preoperatively (1 ml) and topically applied during CI (0.5 ml). The extent of hearing preservation (HP) after CI and the change in the bithermal caloric response were evaluated. Hearing level was calculated using mean thresholds [(250 Hz + 500 Hz + 1,000 Hz + 2,000 Hz)/4]. Preoperative hearing thresholds were similar in the steroid-administered and control groups (100.92 ± 12.60 vs. 103.29 ± 14.39 dB, p = 0.650). The mean thresholds significantly increased in both groups after surgery (108.46 ± 14.08 dB, p = 0.006, for the steroid-administered group; 117.50 ± 6.34 dB, p = 0.027, for the control group), and the difference between the groups was also significant (p = 0.027). The postoperative shift in the hearing thresholds at frequencies of 500 and 1,000 Hz was significant in the steroid-administered group and that at the frequencies of 500, 1,000 and 2,000 Hz was significant in the control group. However, the extent of the shift in hearing threshold levels at each frequency was not significantly different between the groups. Preservation of hearing thresholds was compared between the groups, and there were significantly more subjects with complete and partial HP in the steroid-administered group than in the control group (p = 0.008). The preoperative caloric response was maintained after CI in the steroid-administered group. This study suggests that the perioperative use of a steroid could minimize the inner ear damage after CI.

Sustained-Release Triamcinolone Acetonide Hydrogels Reduce Hearing Threshold Shifts in a Model for Cochlear Implantation with Hearing Preservation

2019 ◽  
Vol 24 (5) ◽  
pp. 237-244
Author(s):  
Clemens Honeder ◽  
Chengjing Zhu ◽  
Julia Clara Gausterer ◽  
Hanna Schöpper ◽  
Navid Ahmadi ◽  
...  
Keyword(s):  
Sustained Release ◽  
Triamcinolone Acetonide ◽  
Cochlear Implantation ◽  
Hearing Threshold ◽  
Hearing Preservation ◽  
Poloxamer 407 ◽  
Histological Evaluation ◽  
Control Group ◽  
Spiral Ganglion Cell ◽  
Temporal Bones

Introduction: In recent years, the preservation of residual hearing has become a major factor in patients undergoing cochlear implantation (CI). In studies attempting to pharmaceutically improve hearing preservation rates, glucocorticoids (GCs) applied perioperatively in many institutions have emerged as a promising treatment regimen. Although dexamethasone is most commonly used and has been applied successfully by various research groups, recently pharmacological properties have been reported to be relatively unsuitable for topical delivery to the inner ear. Consequently other glucocorticoids merit further evaluation. The aim of this study was therefore to evaluate the otoprotective effects of the topical application of a sustained-release triamcinolone acetonide (TAAC) hydrogel in CI with hearing preservation. Methods: Normal-hearing pigmented guinea pigs were randomized into a group receiving a single dose of a 6% TAAC poloxamer 407 hydrogel, a group receiving a 30% TAAC hydrogel and a control group. All hydrogel applications were performed 1 day prior to CI. After a cochleostomy was drilled, a specifically designed silicone electrode was inserted into the scala tympani for 5 mm. Frequency-specific compound action potentials of the auditory nerve (0.5–32 kHz) were measured pre- and directly postoperatively as well as on days 3, 7, 14, 21, and 28. Finally, temporal bones were harvested for histological evaluation. Results: Application of the TAAC hydrogels resulted in significantly reduced hearing threshold shifts in low, middle and high frequencies and improved spiral ganglion cell survival in the second turn of the cochlea. Outer hair cell numbers in the basal and second turn of the cochlea were slightly reduced after TAAC application. Conclusion: In summary, we were able to demonstrate functional benefits of a single preoperative application of a TAAC hydrogel in a guinea pig model for CI, which persisted until the end of the observational period, that is, 28 days after surgery.

Delayed loss of residual hearing in Clarion® cochlear implant users

2003 ◽  
Vol 117 (11) ◽  
pp. 850-853 ◽  
Author(s):  
M. Barbara ◽  
A. Mattioni ◽  
S. Monini ◽  
I. Chiappini ◽  
F. Ronchetti ◽  
...  
Keyword(s):  
Cochlear Implant ◽  
Cochlear Implantation ◽  
Pure Tone ◽  
Hearing Threshold ◽  
Auditory Threshold ◽  
Residual Hearing ◽  
Equal Distribution ◽  
Hearing Thresholds ◽  
Number Of Patients ◽  
Over Time

Hearing threshold has been measured in a group of patients following cochlear implantation with a Clarion® device for the last eight years. The patients had received either a pre-curved carrier or the Hi-Focus I plus Electrode Positioner System (EPS). The assessment was carried out within the first post-operative week as well as at a later stage, between six and 87 months, post-operatively. Residual hearing thresholds were still measurable early after surgery in 24.5 per cent of the patients, without differences between the two different Clarion® models. However, the number of subjects with measurable hearing dropped to 16.3 per cent as observed when hearing was measured at a later stage, with an equal distribution between the two groups of patients. From this study it has been possible to observe that only a limited number of patients maintain residual hearing after Clarion® cochlear implantation, and that this tends to decrease further over time. Nevertheless, the performance of these patients for speech tests did not appear to be affected by deterioration of the pure-tone auditory threshold.

scholarly journals Variation in the Hearing Threshold in Women during the Menstrual Cycle

2017 ◽  
Vol 21 (04) ◽  
pp. 323-328 ◽  
Author(s):  
Dayse Souza ◽  
Brunna Luckwu ◽  
Wagner Andrade ◽  
Luciane Pessoa ◽  
João Nascimento ◽  
...  
Keyword(s):  
Menstrual Cycle ◽  
Hearing Threshold ◽  
Hormonal Contraceptives ◽  
Control Group ◽  
Hormonal Changes ◽  
High Frequencies ◽  
Hearing Thresholds ◽  
Hormonal Fluctuations ◽  
The Mean ◽  
Late Follicular Phase

Introduction The hormonal changes that occur during the menstrual cycle and their relationship with hearing problems have been studied. However, they have not been well explained. Objective The objective of our study is to investigate the variation in hearing thresholds in women during the menstrual cycle. Method We conducted a cohort and longitudinal study. It was composed of 30 volunteers, aged 18–39 years old, of which 20 were women during the phases of the menstrual cycle and 10 were men (control group) who underwent audiometry and impedance exams, to correlate the possible audiological changes in each phase of the menstrual cycle. Results There were significant changes in hearing thresholds observed during the menstrual cycle phases in the group of women who used hormonal contraceptives and the group who did not use such contraceptives. Improved hearing thresholds were observed in the late follicular phase in the group who did not use hormonal contraceptives and the hearing thresholds at high frequencies were better. Throughout the menstrual cycle phases, the mean variation was 3.6 db HL between weeks in the group who used hormonal contraceptives and 4.09 db HL in the group who did not use them. Conclusions The present study found that there may be a relationship between hearing changes and hormonal fluctuations during the menstrual cycle based on changes in the hearing thresholds of women. In addition, this study suggests that estrogen has an otoprotective effect on hearing, since the best hearing thresholds were found when estrogen was at its maximum peak.

scholarly journals Association between Ocular Pseudoexfoliation and Sensorineural Hearing Loss

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Nandini Vijaya Singham ◽  
Mimiwati Zahari ◽  
Mohammadreza Peyman ◽  
Narayanan Prepageran ◽  
Visvaraja Subrayan
Keyword(s):  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
Hearing Threshold ◽  
Pure Tone Audiometry ◽  
The Body ◽  
Sensorineural Hearing ◽  
Control Group ◽  
Speech Comprehension ◽  
Hearing Thresholds ◽  
Significant Difference

Background. Our study aimed to investigate an association between ocular pseudoexfoliation (PXF) and sensorineural hearing loss (SNHL) and to compare them with age and sex matched controls without pseudoexfoliation.Method. This was a case-control study of 123 patients which included 68 cases with PXF (at least one eye) and 55 controls without pseudoexfoliation. Pure-tone audiometry (PTA) was done for these patients at sound frequencies taken as important for speech comprehension, that is, 250 Hertz (Hz), 500 Hz, 1000 Hz, and 2000 Hz.Results. There were 41 patients with pseudoexfoliation syndrome (PXE) and 27 with pseudoexfoliative glaucoma (PXEG). The majority of patients with hearing loss (60%;n=51) were PXF patients and the remaining 40%(n=34)were controls. Below average hearing thresholds were significantly higher in the pseudoexfoliation group compared to the control group (P=0.01; odds ratio (OR), 3.00; 95% confidence interval (CI), 1.25–7.19). However, there was no significant difference in the mean hearing threshold levels between the three groups (PXE, PXEG, and controls) in either ear (ANOVA, right ear:P=0.46and left earP=0.36).Conclusion. Our study found an association between PXF and SNHL, confirming that PXF can involve organs in the body other than the eye.

scholarly journals Is exposure to personal music players a confounder in adolescent mobile phone use and hearing health studies?

2018 ◽  
Vol 46 (11) ◽  
pp. 4527-4534 ◽  
Author(s):  
Geza Benke ◽  
Christina Dimitriadis ◽  
Berihun M. Zeleke ◽  
Imo Inyang ◽  
Dean McKenzie ◽  
...  
Keyword(s):  
Mobile Phone ◽  
Mobile Phones ◽  
Pure Tone ◽  
Hearing Threshold ◽  
Pure Tone Audiometry ◽  
Mobile Phone Use ◽  
Hearing Thresholds ◽  
Significant Difference ◽  
Health Studies ◽  
The Difference

Objective This study was performed to determine whether exposure to personal music players (PMPs) in the immediate morning prior to hearing testing confounds the association between mobile phone use and hearing thresholds of adolescents. Design In this cohort study of cognitive function in year 7 students (median age 13 years, range 11–14), information regarding the weekly use of mobile phones and the use of PMPs was assessed by a questionnaire. Pure-tone audiometry was used to establish hearing thresholds for all participants. Results Among a cohort of 317 adolescents (60.9% females), 130 were unexposed to PMP use while 33 were exposed to PMP use in the morning prior to hearing testing. No statistically significant difference in hearing threshold shifts was found between adolescents who were and were not exposed to PMP use prior to hearing testing. Likewise, the difference in the use of mobile phones according to the PMP use status was not statistically significant. Conclusion Exposure to PMPs prior to hearing testing did not introduce confounding in the present study of mobile phone use and hearing loss among adolescents.

scholarly journals The Clinical Effects of Steroids Therapy in the Preserving Residual Hearing after Cochlear Implantation with the OTICON Neuro Zti EVO

2021 ◽  
Vol 10 (13) ◽  
pp. 2868
Author(s):  
Magdalena B. Skarzynska ◽  
Aleksandra Kolodziejak ◽  
Elżbieta Gos ◽  
Piotr H. Skarzynski
Keyword(s):  
Cochlear Implant ◽  
Body Mass ◽  
Steroid Therapy ◽  
Cochlear Implantation ◽  
Control Group ◽  
Clinical Effects ◽  
Residual Hearing ◽  
Intravenous Steroid ◽  
Hearing Thresholds ◽  
Implant System

Background: A prospective clinical study was conducted to investigate whether two different pharmacotherapy strategies of steroid administration impact hearing preservation in adult patients who underwent cochlear implantation with the Oticon Medical Neuro cochlear implant system. Methods: Twenty nine adult participants were included. Pure tone audiometry was performed before implantation, during processor activation and 12 months after activation. There were three treatment groups: (1) intravenous steroid therapy (standard steroid therapy with dexamethasone administrated intravenously at the dose 0.1 mg/kg body mass twice a day); (2) combined oral and intravenous steroid therapy (extended steroid therapy with dexamethasone administrated intravenously at the dose 0.1 mg/kg b.m. twice a day and prednisone (orally) at the dose 1 mg/kg body mass/24 h), and (3) no steroid therapy (a control group). Patients’ hearing thresholds before implantation were on average 103 dB HL, 89 dB HL, and 93 dB HL, respectively. Results: Deterioration of hearing thresholds was observed in all three patients’ groups. Twelve months after surgery the patients with and without steroid therapy had similar hearing thresholds. Conclusions: The steroid regimen used in this study did not play a significant role in patients with non-functional residual hearing, who underwent cochlear implantation with the Oticon Medical Neuro cochlear implant system.

scholarly journals Vestibular Function After Cochlear Implantation in Partial Deafness Treatment

2021 ◽  
Vol 12 ◽  
Author(s):  
Magdalena Sosna-Duranowska ◽  
Grazyna Tacikowska ◽  
Elzbieta Gos ◽  
Anna Krupa ◽  
Piotr Henryk Skarzynski ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Cochlear Implantation ◽  
Low Frequency ◽  
Vestibular Function ◽  
Hearing Preservation ◽  
Caloric Test ◽  
Profound Hearing Loss ◽  
Single Sided Deafness ◽  
Caloric Response ◽  
Vestibular Damage

Introduction: Cochlear implantation is a fully accepted method of treating individuals with profound hearing loss. Since the indications for cochlear implantation have broadened and include patients with low-frequency residual hearing, single-sided deafness, or an already implanted ear (meaning bilateral cochlear implantation), the emphasis now needs to be on vestibular protection.Materials and Methods: The research group was made up of 107 patients operated on in the otorhinolaryngosurgery department: 59 females and 48 males, aged 10.4–80.2 years (M = 44.4; SD = 18.4) with hearing loss lasting from 1.4 to 56 years (M = 22.7; SD = 13.5). The patients underwent cVEMP, oVEMP, a caloric test, and vHIT assessment preoperatively, and, postoperatively, cVEMP and oVEMP at 1–3 months and a caloric test and vHIT at 4–6 months.Results: After cochlear implantation, there was postoperative loss of cVEMP in 19.2% of the patients, oVEMP in 17.4%, reduction of caloric response in 11.6%, and postoperative destruction of the lateral, anterior, and posterior semicircular canal as measured with vHIT in 7.1, 3.9, and 4% respectively.Conclusions: Hearing preservation techniques in cochlear implantation are connected with vestibular protection, but the risk of vestibular damage in never totally eliminated. The vestibular preservation is associated with hearing preservation and the relation is statistically significant. Informed consent for cochlear implantation must include information about possible vestibular damage. Since the risk of vestibular damage is appreciable, preoperative otoneurological diagnostics need to be conducted in the following situations: qualification for a second implant, after otosurgery (especially if the opposite ear is to be implanted), having a history of vestibular complaints, and when there are no strict audiological or anatomical indications on which side to operate.

scholarly journals Low-Frequency Hearing Preservation With Long Electrode Arrays: Inclusion of Unaided Hearing Threshold Assessment in the Postoperative Test Battery

2020 ◽  
Vol 29 (1) ◽  
pp. 1-5 ◽  
Author(s):  
Margaret T. Dillon ◽  
Emily Buss ◽  
Brendan P. O'Connell ◽  
Meredith A. Rooth ◽  
English R. King ◽  
...  
Keyword(s):  
Hearing Threshold ◽  
Low Frequency ◽  
Electrode Array ◽  
Hearing Preservation ◽  
Acoustic Stimulation ◽  
Electrode Arrays ◽  
Hearing Sensitivity ◽  
Hearing Thresholds ◽  
Electric Acoustic Stimulation ◽  
Initial Activation

Purpose The goal of this work was to evaluate the low-frequency hearing preservation of long electrode array cochlear implant (CI) recipients. Method Twenty-five participants presented with an unaided hearing threshold of ≤ 80 dB HL at 125 Hz pre-operatively in the ear to be implanted. Participants were implanted with a long (31.5-mm) electrode array. The unaided hearing threshold at 125 Hz was compared between the preoperative and postoperative intervals (i.e., initial CI activation, and 1, 3, 6, 9, and 12 months after activation). Results Eight participants maintained an unaided hearing threshold of ≤ 80 dB HL at 125 Hz postoperatively. The majority ( n = 5) demonstrated aidable low-frequency hearing at initial activation, whereas 3 other participants experienced an improvement in unaided low-frequency hearing thresholds at subsequent intervals. Conclusions CI recipients can retain residual hearing sensitivity with fully inserted long electrode arrays, and low-frequency hearing thresholds may improve during the postoperative period. Therefore, unaided hearing thresholds obtained within the initial weeks after surgery may not reflect later hearing sensitivity. Routine measurement of postoperative unaided hearing thresholds—even for patients who did not demonstrate aidable hearing thresholds initially after cochlear implantation—will identify CI recipients who may benefit from electric–acoustic stimulation. Supplemental Material https://doi.org/10.23641/asha.11356637

Effect of irradiation on guinea pig ABR thresholds

1992 ◽  
Vol 107 (6_part_1) ◽  
pp. 763-768 ◽  
Author(s):  
J. Scott Greene ◽  
Neil A. Giddings ◽  
John T. Jacobson
Keyword(s):  
Guinea Pigs ◽  
Auditory Brainstem ◽  
Control Group ◽  
Hearing Thresholds ◽  
Number Of Patients ◽  
Brainstem Response ◽  
Radiation Induced ◽  
The Difference ◽  
The Right ◽  
Temporal Bones

A significant number of patients undergo Irradiation to the temporal bone for malignancies. Conflicting reports exist regarding the effects of irradiation on hearing thresholds. Although radiation-induced otitis media and osteoradionecrosis of the ossicles with resultant conductive hearing loss are well-documented, there is disagreement regarding the effect of irradiation on sensorineural hearing. Previous animal models, relying only on behavioral tests and reflex thresholds, have failed to reveal consistent threshold shifts after irradiation. However, with the advent of auditory brainstem response (ABR) testing, a reliable objective measurement of hearing in animals is available. Hearing thresholds were determined bilaterally by ABR testing in 21 albino guinea pigs. The left temporal bones of sixteen animals were then Irradiated with a total dose ranging from 5750 to 7000 cGy over 7 weeks. The right ears of these animals, plus both ears of five nonlrradlated guinea pigs, served as controls. Follow-up threshold ABRs were obtained immediately post-irradlation (RT), and at 6 and 12 months post-RT. Average thresholds in all groups increased over time: 60 dB in the control group; 53 dB in the control ears of the Irradiated animals; and 46 dB in the Irradiated ears. There were no statistically significant increases in ABR thresholds for Irradiated ears vs. control ears. At the 6-month followup, hearing was actually better in the Irradiated ears than the control ears and this difference between ears was significantly greater than the difference at baseline ( p < 0.026). Overall, there was no evidence that irradiation produces changes in ABR thresholds.

scholarly journals Inflammation and hearing status in mid-childhood and mid-life: a population-based cross-sectional study

2019 ◽  
Vol 48 (5) ◽  
pp. 1556-1566 ◽  
Author(s):  
Jing Wang ◽  
Valerie Sung ◽  
Peter Carew ◽  
Richard S Liu ◽  
David Burgner ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Hearing Threshold ◽  
Population Based ◽  
Cross Sectional Study ◽  
Communicable Diseases ◽  
Hearing Level ◽  
Sectional Study ◽  
Cross Sectional ◽  
Non Communicable Diseases ◽  
Hearing Thresholds

Abstract Background Lifelong inflammation – known to be associated with many non-communicable diseases – has not been thoroughly investigated in hearing. We aimed to determine if glycoprotein A (GlycA), a novel biomarker of chronic inflammation, is associated with hearing acuity in mid-childhood and mid-life. Methods Population-based cross-sectional study within the Longitudinal Study of Australian Children with plasma GlycA and audiometry data (1169 children and 1316 parents). We calculated high Fletcher Index (mean threshold across 1, 2 and 4 kHz), defining hearing loss as threshold >15 decibel hearing level (dB HL) (better ear). Linear/logistic regression quantified associations of GlycA with hearing threshold/loss. Results Mean [standard deviation (SD)] high Fletcher Indices (dB HL) were 8.0 (5.7) for children and 13.1 (6.9) for adults, with 8.7% and 26.1% respectively showing hearing loss. 1-SD rise in GlycA (children 0.13 mmol/L, adults 0.17 mmol/L) predicted higher hearing thresholds for the lower individual frequencies [1 kHz: children β 0.8, 95% confidence interval (CI) 0.3–1.3; adults β 0.8, 95% CI 0.2–1.4]. This same pattern was evident for the high Fletcher Index (children β 0.7, 95% CI 0.3–1.1; adults β 0.8, 95% CI 0.3–1.4). This translated into 1-SD rise in GlycA predicting adult hearing loss [odds ratio (OR) 1.2, 95% CI 1.0–1.5] with similar but attenuated patterns in children. Conclusions GlycA is associated with poorer hearing by mid-childhood. This potentially reframes hearing loss as a life-course condition with inflammatory antecedents common to other non-communicable diseases. Replication and mechanistic studies could inform causal inference and early prevention efforts.

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