Delivery of pharmaceuticals to the cochleae of patients with auditory
dysfunction could potentially have many benefits from enhancing auditory nerve
survival to protecting remaining sensory cells and their neuronal connections.
Treatment would require platforms to enable drug delivery directly to the
cochlea and increase the potential efficacy of intervention. Cochlear implant
recipients are a specific patient subset that could benefit from local drug
delivery as more candidates have residual hearing; and since residual hearing
directly contributes to post-implantation hearing outcomes, it requires
protection from implant insertion-induced trauma. This study assessed the
feasibility of utilizing microparticles for drug delivery into cochlear fluids,
testing persistence, distribution, biocompatibility, and drug release
characteristics. To allow for delivery of multiple therapeutics, particles were
composed of two distinct compartments; one containing polylactide-co-glycolide
(PLGA), and one composed of acetal-modified dextran and PLGA. Following
in vivo infusion, image analysis revealed microparticle
persistence in the cochlea for at least 7 days post-infusion, primarily in the
first and second turns. The majority of subjects maintained or had only slight
elevation in auditory brainstem response thresholds at 7 days post-infusion
compared to pre-infusion baselines. There was only minor to limited loss of
cochlear hair cells and negligible immune response based on CD45+ immunolabling.
When Piribedil-loaded microparticles were infused, Piribedil was detectable
within the cochlear fluids at 7 days post-infusion. These results indicate that
segmented microparticles are relatively inert, can persist, release their
contents, and be functionally and biologically compatible with cochlear function
and therefore are promising vehicles for cochlear drug delivery.