Factors influencing the efficacy of round window dexamethasone protection of residual hearing post-cochlear implant surgery

Chang, Andrew; Eastwood, Hayden; Sly, David; James, David; Richardson, Rachael T.; O’Leary, Stephen

doi:10.1016/j.heares.2009.05.010

Cited by 99 publications

(94 citation statements)

References 35 publications

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“…The factors that determine preservation of residual hearing are type and dimension of array [2,3], traditional cochleostomy vs. round window insertion) [4,5], insertion technique [3,6] and drugs used during insertion [7,8]. Soft surgery technique with round window insertion has played a major part among the steps taken for residual hearing preservation in the last decade.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Round Window Accessibility for Electrode Insertion: Validation Study from two Centers

Panda¹

2017

JOENTR

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Purpose: Round window insertion is advocated as a method to reduce insertion trauma and preserve residual hearing. Bony overhang of the round window niche and variations in the cochlear rotation might hamper the accessibility of round window membrane. This paper is an attempt to classify the round window membrane visibility before any drilling of the round window niche through the standard posterior tympanotomy approach.

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Section: Introductionmentioning

confidence: 99%

Evaluation of Round Window Accessibility for Electrode Insertion: Validation Study from two Centers

Panda¹

2017

JOENTR

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“…6 In addition to steroids, the use of lubricating fluids or gels applied onto the electrode array, such as Hyaluronic acid was shown to reduce friction forces during electrode insertion, potentially limiting the insertion trauma. 7,8 Finally, the combination of both steroids and hyaluronic acid was sometimes more efficient than the use of either solution alone.…”

Section: Introductionmentioning

confidence: 99%

Short-Term Clinical Outcome of Neuro One<sup>®</sup> System Cochlear Implantation in Korean Adults

Lee¹,

Kim²,

Chang³

2018

Korean J Otorhinolaryngol-Head Neck Surg

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Introduction The preservation of residual hearing is currently an important challenge for cochlear implant surgeries. Indeed, if patients exhibit functional hearing after cochlear implantation, they can benefit from the combination of acoustical stimulation, usually in the low-frequencies and electrical stimulation in the high-frequencies. This combined mode of stimulation has proven to be beneficial both in terms of speech perception and of sound quality. Finding the right procedures for conducting softsurgeries and designing electrode arrays dedicated to hearing preservation is an open issue. Objective The objective of this study is to evaluate the combination of a soft-surgery procedure implicating round-window insertion and the use of dexamethasone and hyaluronic acid during surgery, with the use of a specifically designed straight soft electrode array, on hearing preservation in patients with functional hearing in the low frequencies. Methods This pre-clinical trial was conducted on seven patients with residual hearing in the low frequencies. The surgical method used employed a round window insertion and the use of topical dexamethasone. Results The soft-surgery protocol could be successfully followed in five patients. In this group, the average hearing threshold shift compared with pre-operative values was of 18.7 þ/À 16.1 dB HL up to 500 Hz and 15.7 þ/À 15.1 up to 1 kHz, demonstrating satisfying levels of hearing preservation. Conclusion We were able to demonstrate the possibility of preserving residual hearing in most of the patients using the EVO electrode. Significant residual hearing preservation levels were was obtained when a soft surgical approach involving round window insertion, dexamethasone and hyaluronic use during the surgery.

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“…However, even with the introduction of minimally traumatic "soft" surgical techniques (reviewed in [5] and [6]) and electrodes that have been modified to reduce intracochlear trauma during their insertion [7], residual hearing is lost or incompletely preserved in one-third of cases [8]. Some researchers have begun to explore the possibility that better hearing preservation may be achieved by the application of protective pharmacological agents to the inner ear at the time of surgery ( [9,10] and [11], reviewed in [6]).…”

Section: Introductionmentioning

confidence: 99%

Growth factor-eluting cochlear implant electrode: impact on residual auditory function, insertional trauma, and fibrosis

Kikkawa

Nakagawa

Ying

et al. 2014

Journal of Translational Medicine

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Background: A cochlear implant (CI) is an artificial hearing device that can replace a damaged cochlea. The present study examined the use of growth factor-eluting gelatin hydrogel coatings on the electrodes to minimize inner ear trauma during electrode insertion. Insulin-like growth factor 1 (IGF1) and/or hepatocyte growth factor (HGF) were chosen as the agents to be administered. Methods: Silicone CI electrode analogs were prepared and coated with gelatin hydrogels. Adsorption/release profile of the hydrogel was measured using

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Factors influencing the efficacy of round window dexamethasone protection of residual hearing post-cochlear implant surgery

Cited by 99 publications

References 35 publications

Evaluation of Round Window Accessibility for Electrode Insertion: Validation Study from two Centers

Evaluation of Round Window Accessibility for Electrode Insertion: Validation Study from two Centers

Short-Term Clinical Outcome of Neuro One<sup>®</sup> System Cochlear Implantation in Korean Adults

Growth factor-eluting cochlear implant electrode: impact on residual auditory function, insertional trauma, and fibrosis

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