Hearing preservation using topical dexamethasone alone and associated with hyaluronic acid in cochlear implantation

Ramos, Bernardo Faria; Tsuji, Robinson Koji; Bento, Ricardo Ferreira; Goffi-Gómez, María Valéria Schmidt; Ramos, Henrique Faria; Samuel, Paola Angélica; Brito, Rubens de

doi:10.3109/00016489.2014.995831

Cited by 17 publications

(12 citation statements)

References 18 publications

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“…9 Pre-operatively, patients received a weight-adjusted intravenous dose of hydrocortisone (4 mg/kg) and a single dose of preventive antibiotic treatment (cefazolin, 1 g), before intubation and general anesthesia. The surgeon then performed a wide posterior tympanotomy via facial recess, allowing exposure of the round window membrane.…”

Section: Hearing Preservation Soft-surgery Protocol and Electrode Arraymentioning

confidence: 99%

“…9 These observations constitute arguments in favor of improving the way drugs can be delivered to the inner ear to favor long-term residual hearing preservation in patients candidates for combined electrical and acoustical stimulation. One option in this domain would be to develop drug-eluting electrode arrays, made with dexamethasone loaded silicones, which could deliver steroids to the inner ear over longer post-surgery periods.…”

Section: 21mentioning

confidence: 99%

“…7,8 Finally, the combination of both steroids and hyaluronic acid was sometimes more efficient than the use of either solution alone. 9 The last line of research developed in this context was the improvement and specific design of electrode arrays optimized for less traumatic insertions. Shorter electrode arrays, meant to cover only the high-frequency regions of the cochlea were developed, but presented very limited interest because of the frequent progressive nature of the hearing-loss affecting patients and the high risk of reimplantation associated.…”

Section: Introductionmentioning

confidence: 99%

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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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Section: Hearing Preservation Soft-surgery Protocol and Electrode Arraymentioning

confidence: 99%

Section: 21mentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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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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“…However, this study involved a heterogeneous group with different electrodes, nonrandomization, nonblinding, different insertion techniques, and inconsistent followup between the 2 groups. The fourth study (and also a randomized trial in this group) found the group with a combination of hyaluronic acid and dexamethasone instilled 15 min prior to electrode insertion had significantly better hearing preservation than the control group [Ramos et al, 2015]. However, the group receiving dexamethasone alone was not significantly better than the control group.…”

Section: Introductionmentioning

confidence: 99%

The Role of Preoperative Steroids for Hearing Preservation Cochlear Implantation: Results of a Randomized Controlled Trial

et al. 2017

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Objectives: To determine whether preoperative steroids can improve hearing outcomes in cochlear implantation (CI). Methods: This is a randomized controlled trial involving 30 postlingual deaf CI patients. Subjects had preoperative thresholds of better than or equal to 80 dB at 125 and 250 Hz, and better than or equal to 90 dB at 500 and 1,000 Hz. The subjects were randomized to a control group, an oral steroid group (receiving 1 mg/kg/day of prednisolone for 6 days prior to surgery), or a transtympanic steroid group (receiving a single dose of 0.5 mL of 10 mg/mL dexamethasone at 24 h prior to surgery). Results: The subjects receiving transtympanic steroids had a significant decrease in the pure tone average over 3 months compared to the control and oral steroid group, which persisted over 12 months (p < 0.05). Conclusion: A single dose of preoperative transtympanic steroids prior to CI appears to have a beneficial effect, at least in the short term, with minimal effects seen in the longer term.

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“…Existem inúmeros trabalhos que descrevem o trauma intracoclear, quando o implante coclear é colocado pela via tradicional de mastoidectomia com timpanotomia posterior para acessar a janela redonda (Ramos et al, 2015;Meshik et al, 2010;Adunka et al, 2006;Briggs et al, 2006Briggs et al, , 2005. Muitos destes trabalhos compararam o acesso pela janela redonda com o acesso por cocleostomia, os diferentes ângulos de inserção, a inserção do feixe por diferentes áreas na janela e o trauma gerado por distintos tipos de feixe de eletrodos, por exemplo os retos contra os perimodiolares.…”

Section: Objetivos Secundáriosunclassified

Avaliação do trauma intracoclear causado pela inserção do feixe de eletrodos do implante coclear via fossa média em ossos temporais

Lesser¹,

Carlos²

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Hearing preservation using topical dexamethasone alone and associated with hyaluronic acid in cochlear implantation

Cited by 17 publications

References 18 publications

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

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

The Role of Preoperative Steroids for Hearing Preservation Cochlear Implantation: Results of a Randomized Controlled Trial

Avaliação do trauma intracoclear causado pela inserção do feixe de eletrodos do implante coclear via fossa média em ossos temporais

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