Role of Glucocorticoids in Hearing Preservation in Partial Deafness Treatment

Abstract

During the last 15 years, cochlear implantation became available as a method of treatment for different types of hearing impairment. Leading, specialized centers have now introduced the analysis of the nonsurgical factors that could contribute to improve rates of hearing preservation in preoperative period, during surgery, or in postoperative period in patients who suffer from partial deafness. One of the approaches is using pharmacotherapy (glucocorticoids) as a factor that may improve hearing functions. Preservation of hearing in patients who suffered from partial deafness and underwent cochlear implantation by using two different regimes of corticosteroid therapy was the aim of the study carried out by the World Hearing Center (WHC). Forty-six patients were enrolled in the trial and divided into three subgroups. Hearing preservation (HP) was evaluated using pure tone audiometry (PTA) (11 frequencies ranging from 125 to 8000 Hz). The impact of administrated substances was evaluated by pure tone audiometry during six different periods: before cochlear implant surgery, during activation of audio processor, and 1, 6, 9, and 12 months after activation of audio processor in comparison with control group. According to hearing preservation (HP) classification, patients from the second group, to whom combined glucocorticoid therapy was administrated, achieved the best HP results. The complete hearing preservation index was observed in the highest percentage of patients from the second subgroup. The dispersion of measured values was lesser than in other subgroups. According to the results, administration of glucocorticoids (dexamethasone and prednisone or dexamethasone only) to the patients, who suffered from partial deafness and underwent cochlear implantation surgery, may be important in stabilization of hearing thresholds and in protection of hearing.

Assessing Gait Stability before and after Cochlear Implantation

“…The surgical technique of operating on the inner ear through a round window (RW) as well as reductions in the size of the implantable part of the cochlear implants has yielded improved effects of surgical intervention [4–6]. In our study group, more than 90% of subjects were operated on using the RW technique.…”

“…Subjects (n=21) for the experimental group were recruited from the World Hearing Center, Institute of Physiology and Pathology of Hearing, Warsaw, Kajetany, Poland. Those qualified for the experimental group were adults identified as partial deafness (PD) patients, having normal low-frequency hearing but no hearing in the high-frequency range [4], scheduled for cochlear implantation (CI). CI is received by patients who find that conventional hearing aids do not bring sufficient benefits; they are qualified for the procedure by a special commission, after a series of specialist tests and consultations.…”

“…The procedure of insertion may induce vestibular disorders after the surgery itself, or after the activation of the cochlear implant [2]. The risk of lost vestibular function may depend in part on the particular surgical method used [3]; the technique of accessing the inner ear through a round window has proved to be an extremely effective method in treating partial deafness [4–6]. The incidence of damage to vestibular function and postoperative complications has been estimated variously in the available literature, from only sporadic cases up to 75% of all adult patients [7–10].…”

Hearing loss treatment with cochlear or brainstem implants in 2014 – diagnostic, needs, availability in various regions of Poland

“…Wówczas stosowane były systemy jednokanałowe, umożliwiające jedynie odbiór podstawowych wrażeń słuchowych. Wraz z pojawieniem się systemów wielokanałowych kryteria kwalifikacji do operacji wszczepienia implantu poszerzyły się i rozpoczęto wszczepianie implantów dzieciom z wrodzonym głębokim niedosłuchem [7,[10][11][12][13].…”

“…W Polsce pierwszej operacji wszczepienia implantu dokonał w 1992 roku prof. Henryk Skarżyński, z kolei w roku 2002 w Instytucie Fizjologii i Patologii Słuchu (IFPS) zainicjował on program leczenia częściowej głuchoty z zastosowaniem implantów ślimakowych [13]. Obecnie rozwiązanie to jest stosowane w wielu ośrodkach w Polsce, jednak IFPS znajduje się w czołówce placówek pod względem liczby hospitalizacji związanych z procedurą wszczepienia systemu implantu ślimakowego nie tylko w Polsce, lecz także na świecie -385 hospitalizacji w 2014 roku [13,14].…”