Deep intracochlear injection of triamcinolone-acetonide with an inner ear catheter in patients with residual hearing
IntroductionIn a previous study, an inner ear catheter was used to deliver low- and high-dose steroids into the cochlea prior to cochlear implant electrode insertion. With this approach, more apical regions of the cochlea could be reached and a reduction of electrode impedances in the short term was...
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| Language: | English |
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Frontiers Media S.A.
2023-07-01
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| Series: | Frontiers in Neuroscience |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fnins.2023.1202429/full |
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| author | Nils K. Prenzler Rolf Salcher Thomas Lenarz Thomas Lenarz Lutz Gaertner Anke Lesinski-Schiedat Athanasia Warnecke Athanasia Warnecke |
| author_facet | Nils K. Prenzler Rolf Salcher Thomas Lenarz Thomas Lenarz Lutz Gaertner Anke Lesinski-Schiedat Athanasia Warnecke Athanasia Warnecke |
| author_sort | Nils K. Prenzler |
| collection | DOAJ |
| description | IntroductionIn a previous study, an inner ear catheter was used to deliver low- and high-dose steroids into the cochlea prior to cochlear implant electrode insertion. With this approach, more apical regions of the cochlea could be reached and a reduction of electrode impedances in the short term was achieved in cochlear implant recipients. Whether intracochlear application of drugs via the catheter is a safe method also for patients with residual hearing has not been investigated hitherto. The aim of the present study was therefore to investigate the effect of intracochlear triamcinolone application in cochlear implant recipients with residual hearing.Patients and methodsPatients with residual hearing were administered triamcinolone-acetonide (4 mg/ml; n = 10) via an inner ear catheter just prior to insertion of a MED-EL FLEX28 electrode. Impedances were measured at defined time points (intra-operatively, post-operatively and at first fitting) and retrospectively compared with a control group (no steroid application) and low- and high-dose group. Hearing thresholds were measured preoperatively, 3 days after surgery and at first fitting by pure tone audiometry. Pre- to postoperative hearing loss was determined at first fitting and compared to results from a previous study.ResultsThe median hearing loss after implantation (125–1,500 Hz) was 20.6 dB. Four patients (40%) showed a median hearing loss of less than 15 dB, three patients (30%) between 15 and 30 dB and three patients (30%) more than 30 dB. The median hearing loss was similar to the results obtained from our previous study showing a median hearing loss of 24 dB when using FLEX28 electrode arrays.ConclusionNo difference in residual hearing loss was found when comparing application of triamcinolone-acetonide using an inner ear catheter prior to the insertion of a FLEX28 electrode array to the use of the FLEX28 electrode array without the catheter. Thus, we conclude that application of drugs to the cochlea with an inner ear catheter could be a feasible approach in patients with residual hearing. |
| first_indexed | 2024-03-12T21:48:32Z |
| format | Article |
| id | doaj.art-b8a5bbc230b3425888cf8a9fe8e73000 |
| institution | Directory Open Access Journal |
| issn | 1662-453X |
| language | English |
| last_indexed | 2024-03-12T21:48:32Z |
| publishDate | 2023-07-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Neuroscience |
| spelling | doaj.art-b8a5bbc230b3425888cf8a9fe8e730002023-07-26T07:21:25ZengFrontiers Media S.A.Frontiers in Neuroscience1662-453X2023-07-011710.3389/fnins.2023.12024291202429Deep intracochlear injection of triamcinolone-acetonide with an inner ear catheter in patients with residual hearingNils K. Prenzler0Rolf Salcher1Thomas Lenarz2Thomas Lenarz3Lutz Gaertner4Anke Lesinski-Schiedat5Athanasia Warnecke6Athanasia Warnecke7Department of Otorhinolaryngology, Head and Neck Surgery, Hannover Medical School, Hanover, GermanyDepartment of Otorhinolaryngology, Head and Neck Surgery, Hannover Medical School, Hanover, GermanyDepartment of Otorhinolaryngology, Head and Neck Surgery, Hannover Medical School, Hanover, GermanyCluster of Excellence “Hearing 4 All” (DFG Exc. 2177), Hannover Medical School, Hanover, GermanyDepartment of Otorhinolaryngology, Head and Neck Surgery, Hannover Medical School, Hanover, GermanyDepartment of Otorhinolaryngology, Head and Neck Surgery, Hannover Medical School, Hanover, GermanyDepartment of Otorhinolaryngology, Head and Neck Surgery, Hannover Medical School, Hanover, GermanyCluster of Excellence “Hearing 4 All” (DFG Exc. 2177), Hannover Medical School, Hanover, GermanyIntroductionIn a previous study, an inner ear catheter was used to deliver low- and high-dose steroids into the cochlea prior to cochlear implant electrode insertion. With this approach, more apical regions of the cochlea could be reached and a reduction of electrode impedances in the short term was achieved in cochlear implant recipients. Whether intracochlear application of drugs via the catheter is a safe method also for patients with residual hearing has not been investigated hitherto. The aim of the present study was therefore to investigate the effect of intracochlear triamcinolone application in cochlear implant recipients with residual hearing.Patients and methodsPatients with residual hearing were administered triamcinolone-acetonide (4 mg/ml; n = 10) via an inner ear catheter just prior to insertion of a MED-EL FLEX28 electrode. Impedances were measured at defined time points (intra-operatively, post-operatively and at first fitting) and retrospectively compared with a control group (no steroid application) and low- and high-dose group. Hearing thresholds were measured preoperatively, 3 days after surgery and at first fitting by pure tone audiometry. Pre- to postoperative hearing loss was determined at first fitting and compared to results from a previous study.ResultsThe median hearing loss after implantation (125–1,500 Hz) was 20.6 dB. Four patients (40%) showed a median hearing loss of less than 15 dB, three patients (30%) between 15 and 30 dB and three patients (30%) more than 30 dB. The median hearing loss was similar to the results obtained from our previous study showing a median hearing loss of 24 dB when using FLEX28 electrode arrays.ConclusionNo difference in residual hearing loss was found when comparing application of triamcinolone-acetonide using an inner ear catheter prior to the insertion of a FLEX28 electrode array to the use of the FLEX28 electrode array without the catheter. Thus, we conclude that application of drugs to the cochlea with an inner ear catheter could be a feasible approach in patients with residual hearing.https://www.frontiersin.org/articles/10.3389/fnins.2023.1202429/fullcochlear implanthearing preservationimpedancessteroidscatheterdrug delivery |
| spellingShingle | Nils K. Prenzler Rolf Salcher Thomas Lenarz Thomas Lenarz Lutz Gaertner Anke Lesinski-Schiedat Athanasia Warnecke Athanasia Warnecke Deep intracochlear injection of triamcinolone-acetonide with an inner ear catheter in patients with residual hearing Frontiers in Neuroscience cochlear implant hearing preservation impedances steroids catheter drug delivery |
| title | Deep intracochlear injection of triamcinolone-acetonide with an inner ear catheter in patients with residual hearing |
| title_full | Deep intracochlear injection of triamcinolone-acetonide with an inner ear catheter in patients with residual hearing |
| title_fullStr | Deep intracochlear injection of triamcinolone-acetonide with an inner ear catheter in patients with residual hearing |
| title_full_unstemmed | Deep intracochlear injection of triamcinolone-acetonide with an inner ear catheter in patients with residual hearing |
| title_short | Deep intracochlear injection of triamcinolone-acetonide with an inner ear catheter in patients with residual hearing |
| title_sort | deep intracochlear injection of triamcinolone acetonide with an inner ear catheter in patients with residual hearing |
| topic | cochlear implant hearing preservation impedances steroids catheter drug delivery |
| url | https://www.frontiersin.org/articles/10.3389/fnins.2023.1202429/full |
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