Improving Clinical Outcomes in Cochlear Implantation Using Glucocorticoid Therapy: A Review

Abstract

Cochlear implant surgery is a successful procedure for auditory rehabilitation of patients with severe to profound hearing loss. However, cochlear implantation may lead to damage to the inner ear, which decreases residual hearing and alters vestibular function. It is now of increasing interest to preserve residual hearing during this surgery because this is related to better speech, music perception, and hearing in complex listening environments. Thus, different efforts have been tried to reduce cochlear implantation-related injury, including periprocedural glucocorticoids because of their anti-inflammatory properties. Different routes of administration have been tried to deliver glucocorticoids. However, several drawbacks still remain, including their systemic side effects, unknown pharmacokinetic profiles, and complex delivery methods. In the present review, we discuss the role of periprocedural glucocorticoid therapy to decrease cochlear implantation-related injury, thus preserving inner ear function after surgery. Moreover, we highlight the pharmacokinetic evidence and clinical outcomes which would sustain further interventions.

Micro Injection Molding of Drug-Loaded Round Window Niche Implants for an Animal Model using 3D Printed Molds

“…In a previous study, we found a slight tendency for DPS to be more effective in reducing TNFα-production than other DEX formulations [16]. Moreover, other glucocorticoids such as prednisone and hydrocortisone (cortisol) offer therapeutic potential for inner ear therapy [51] and are promising for inclusion in further investigations.…”

The Clinical Effect of Steroids for Hearing Preservation in Cochlear Implantation: Conclusions Based on Three Cochlear Implant Systems and Two Administration Regimes

“…According to the current clinical indications for cochlear implantation (CI), which have been progressively expanded, candidates for the procedure are those with partial deafness (PDT, partial deafness treatment), children with congenital profound hearing loss, single-sided deafness patients, and those over 65 years of age, as well as those with acquired bilateral sensory hearing loss [ 1 , 2 , 3 ]. Some years ago, it would be very challenging, or even impossible, to preserve residual hearing after CI surgery [ 4 , 5 ].…”

Dexamethasone Conjugates: Synthetic Approaches and Medical Prospects

“…DEX is used to treat many conditions, including rheumatoid arthritis, bronchial asthma, systemic lupus erythematosus, autoimmune diseases, shocks of various etiologies, skin allergic diseases (neurodermatitis, eczema), and chronic rhinosinusitis, as well as to suppress transplant graft rejection [5,18,34,[56][57][58][59][60][61][62][63][64]. DEX readily penetrates the conjunctiva, so it is one of the most commonly used GCs for the treatment of ocular conditions, including inflammation diseases of both the anterior (keratitis, blepharitis, allergic DEX has good oral bioavailability; it is rapidly and completely absorbed in the gastrointestinal tract and had an elimination half-life of 1-2 h. After intramuscular injection, DEX sodium phosphate is absorbed slowly, with the maximum plasma concentration reached after 7-9 h and an elimination half-life of 3-5 h. In the blood, 60-70% of the DEX binds to a specific transporter protein (transcortin).…”

“…DEX is used to treat many conditions, including rheumatoid arthritis, bronchial asthma, systemic lupus erythematosus, autoimmune diseases, shocks of various etiologies, skin allergic diseases (neurodermatitis, eczema), and chronic rhinosinusitis, as well as to suppress transplant graft rejection [5,18,34,[56][57][58][59][60][61][62][63][64]. DEX readily penetrates the conjunctiva, so it is one of the most commonly used GCs for the treatment of ocular conditions, including inflammation diseases of both the anterior (keratitis, blepharitis, allergic conjunctivitis, and dry eye) and the posterior (choroiditis, uveitis, age-related macular degeneration, diabetic macular edema, and diabetic retinopathy) segments [5,7,[65][66][67][68][69][70][71].…”