Current Concepts and Future Trends in Increasing the Benefits of Cochlear Implantation: A Narrative Review

Blebea, Cristina Maria; Ujvary, Laszlo Peter; Necula, Violeta; Dindelegan, Maximilian George; Perde-Schrepler, Maria; Stamate, Mirela Cristina; Cosgarea, Marcel; Maniu, Alma

doi:10.3390/medicina58060747

Cited by 8 publications

(8 citation statements)

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“…A perda auditiva consiste em uma deficiência relacionada ao prejuízo parcial ou total do ouvir, o que limita o indivíduo no meio social e profissional. Nesse sentido, é o distúrbio neurossensorial mais comum quando se considera todos os déficits sensoriais e carrega um enorme fardo econômico e social, impactando consideravelmente a qualidade de vida dos pacientes (BLEBEA CM, et al, 2022).…”

Section: Introductionunclassified

Perda auditiva e implante coclear

Amorim¹,

Siqueira²

2023

Acervo Médico

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Objetivo: Analisar as características do Implante Coclear (IC), seu funcionamento, suas indicações e complicações. Revisão bibliográfica: Mais de 500 milhões de pessoas em todo o mundo sofrem de perda auditiva, a qual pode comprometer a comunicação por ocasionar danos no desenvolvimento de habilidades cognitivas, emocionais, educacionais, socioeconômicas, além de influenciar de forma negativa a dinâmica familiar do indivíduo. Nesse sentido, o IC tem sido a tecnologia que gera expectativas e traz benefícios para indivíduos com DA neurossensorial severa e/ou profunda que não se beneficiam de outros aparelhos auditivos. Os ICs contornam o mecano transdutor natural do ouvido interno e fornecem estimulação elétrica diretamente aos neurônios auditivos. Para os indivíduos com perda auditiva severa a profunda, especialmente bilateral, a melhor terapêutica é o implante coclear. Considerações finais: O diagnóstico precoce e preciso é crucial para o sucesso da reabilitação auditiva da deficiência auditiva de alto grau. A reabilitação auditiva com o implante coclear está associada à melhora significativa, não apenas da audição e da compreensão da linguagem falada, mas também da qualidade de vida em qualquer faixa etária.

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Section: Introductionunclassified

Perda auditiva e implante coclear

Amorim¹,

Siqueira²

2023

Acervo Médico

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“…Reducing cochlear damage and preserving the residual hearing capacity has long been a primary objective of inner ear procedures, particularly cochlear implantation (CI) [ 1 ]. In recent years, growing interest can be observed regarding hearing conservation in candidates for hybrid, electro-acoustic stimulation whose residual hearing levels may be affected during CI [ 2 , 3 ].…”

Section: Introductionmentioning

confidence: 99%

“…The loss of hearing remnants following CI surgery, especially for low frequencies, generally presents two possible outcomes: an early and a late phase. The immediate loss of residual hearing can be due to insertion trauma (fracture of the osseous spiral lamina, displacement of the basilar membrane, damage to the stria vascularis, or disturbance of the cochlear fluids) and the subsequent inflammatory response [ 1 ]. Later residual hearing loss can occur months after implantation.…”

Section: Introductionmentioning

confidence: 99%

“…The prospects of HPCI have greatly increased with the development of less traumatic electrodes, in conjunction with the application of soft surgery principles [ 8 ]. As surgical principles and electrode design have been extensively studied, attention is shifting toward new solutions, such as assisted electrode insertion or otoprotective pharmacological support through either systemic or local drug delivery [ 1 ]. Local drug delivery using novel nanoparticles (NPs) via the intratympanic or intracochlear route is intended to generate high localized concentrations while avoiding any systemic side effects.…”

Section: Introductionmentioning

confidence: 99%

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The Effect of Pluronic-Coated Gold Nanoparticles in Hearing Preservation Following Cochlear Implantation-Pilot Study

et al. 2022

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Introduction: During cochlear implantation, electrode insertion can cause cochlear damage, inflammation, and apoptosis, which can affect the residual hearing. Nanoparticles are increasingly studied as a way to increase the availability of inner ear protective factors. We studied the effect on rats of Pluronic-coated gold nanoparticles (Plu-AuNPs) containing dexamethasone, which were applied locally in the rat’s middle ear following the implant procedure. Methods: Seven rats were used in the study. The right ear served as a model for the Dex-Plu-AuNP group. Following the intracochlear dummy electrode insertion through the round window, Dex-Plu-AuNPs were placed in the round window niche. In the right ear, following the same insertion procedure, free dexamethasone (Dex) was placed in the same manner. Auditory brainstem response thresholds (click stimulus, pure tones at 8 kHz, 16 kHz, 24 kHz, and 32 kHz) were measured before and one week after the procedure. A two-tailed T-test was used for the variables. Statistical significance was set as p < 0.05. Results: In the Dex-Plu-AuNP group, the threshold shift was less than that in the free dexamethasone group, but no statistical significance was noted between the groups. When compared individually, only the 8 kHz frequency showed statistically significant, better results after one week, in favor of the Dex-Plu-AuNP group. The mean postoperative 8 kHz threshold in the Dex-Plu-AuNPs was significantly lower than that of the control group (p = 0.048, t-test). For the other frequencies, statistical analysis showed no significant differences between the mean threshold shifts of the two cohorts. Conclusions: The local application of Plu-AuNPs containing dexamethasone following cochlear implantation may better protect the residual hearing than dexamethasone alone, but a larger sample size is needed to reach a possible statistical significance. Dex-Plu-AuNPs do not seem to cause ototoxicity and may be used as a carrier for other agents. In a clinical setting, Dex-Plu-AuNPs may have the effect of protecting lower frequencies in patients with partial deafness who are candidates for electric acoustic stimulation (EAS). If we consider this tendency, Dex-Plu-AuNPs may also be beneficial for patients with Ménière’s disease.

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“…In otology, experimental models aided in the exploration of pathways for therapeutic agents administration, including intratympanic drug distribution, cochlear transportation via the round window (RW) or the oval window (OW) (Dindelegan et al, 2022). As cochlear implantation became a standard of care for profound hearing loss, association with different types of drug delivery methods, stem cell therapy as well as gene therapy became the new focal point (Blebea et al, 2022).…”

Section: Introductionmentioning

confidence: 99%

Relevant Anatomical Details in Rats Regarding Otologic Research

Blebea¹,

Dindelegan²,

Ujvary³

et al. 2022

Int. J. Morphol.

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The objective of the study was to provide a detailed anatomical description of the rat's ear anatomy that will prove insightful to different experimental otologic surgical procedures regardless of scope. Three male Wistar rats were enrolled in the study. Candidates were screened for systemic and otologic pathology. External ear canal endoscopy was carried out with a 30˚ rigid endoscope through an image capture system. Middle ear anatomical elements were analyzed under stereomicroscopy. 3D computer tomography image reconstruction was realized with a micro-CT to describe the anatomy. Image data from all three rats were analyzed. Anatomical annotations and surgical exposure recommendations were added for key elements. The most relevant images from all three rats were selected for representation. Detailed visualization of the structural elements of the tympanic cavity were clearly visible: promontory, round window, stapedial artery, stapes, incus, and tympanic membrane were all constant findings. We describe a step wise ventral surgical approach of the middle and inner ear for which we found that the clavotrapezius muscle was a reliable landmark. For the transtympanic approach the endoscopic transcanal access was an easy and reliable method for which a detailed anatomical representation was depicted. Further, anatomical similarities to humans were observed by stereomicroscopy and Micro-CT imaging reiterating that the rat model is suitable for otologic research. The endoscopic approach to the tympanic membrane is comfortable and less expensive than a microscope. The tendon of the clavotrapezius muscle can be a reliable landmark for discovering the tympanic bulla when considering a ventral approach. 3D Micro-CT reconstruction allows intact evaluation of the samples, simultaneously being a diagnostic and also a learning tool.

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Current Concepts and Future Trends in Increasing the Benefits of Cochlear Implantation: A Narrative Review

Cited by 8 publications

References 103 publications

Perda auditiva e implante coclear

Perda auditiva e implante coclear

The Effect of Pluronic-Coated Gold Nanoparticles in Hearing Preservation Following Cochlear Implantation-Pilot Study

Relevant Anatomical Details in Rats Regarding Otologic Research

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