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

Abstract Conclusion: Topical dexamethasone associated with hyaluronic acid in cochlear implant surgery demonstrated a statistically significant difference in the preservation of low-frequency thresholds when compared with topical dexamethasone alone and a control group. Topical dexamethasone alone was not superior in hearing preservation when compared to the control group. Objective: To compare the effects of topical dexamethasone alone and associated with hyaluronic acid intraoperatively in hearing preservation in cochlear implantation. Methods: Eighteen severely to profoundly hearing-impaired adult patients with measurable hearing were divided into three groups preoperatively: cochlear implantation as a control group (group 1), cochlear implantation using topical dexamethasone intraoperatively (group 2), and cochlear implantation using topical dexamethasone associated with hyaluronic acid intraoperatively (group 3). Preimplant and postimplant low-frequency pure-tone averages (PTAs) were calculated from unaided audiograms at 125, 250, and 500 Hz. Results: The mean changes in the low-frequency PTA comparing postoperative against preoperative thresholds were 28.03 ± 6.77 dB in group 1, 30 ± 14.53 dB in group 2, and 7.23 ± 6.12 dB in group 3. There was statistical difference when comparing group 3 with groups 1 and 2 using one-way ANOVA (p = 0.002) followed by Scheffé post hoc test.

[1]  A. Büchner,et al.  Effect of gender on the hearing performance of adult cochlear implant patients , 2012, The Laryngoscope.

[2]  N. Quaranta,et al.  The Role of Hearing Preservation on Electrical Thresholds and Speech Performances in Cochlear Implantation , 2012, Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology.

[3]  G. Rajan,et al.  The role of preoperative, intratympanic glucocorticoids for hearing preservation in cochlear implantation: A prospective clinical study , 2012, The Laryngoscope.

[4]  René H Gifford,et al.  Implications of Minimizing Trauma During Conventional Cochlear Implantation , 2011, Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology.

[5]  A. Eshraghi,et al.  Mechanisms of hearing loss from trauma and inflammation: otoprotective therapies from the laboratory to the clinic. , 2010, Acta oto-laryngologica.

[6]  H. Eastwood,et al.  Factors influencing the efficacy of round window dexamethasone protection of residual hearing post-cochlear implant surgery , 2009, Hearing Research.

[7]  Thomas Lenarz,et al.  Hearing Conservation Surgery Using the Hybrid-L Electrode , 2009, Audiology and Neurotology.

[8]  W. Baumgartner,et al.  An evaluation of the preservation of residual hearing with the Nucleus® Contour Advance™ electrode , 2009, Acta oto-laryngologica.

[9]  H. Eastwood,et al.  Effects of Round Window Dexamethasone on Residual Hearing in a Guinea Pig Model of Cochlear Implantation , 2007, Audiology and Neurotology.

[10]  R. Cowan,et al.  Effects of steroids and lubricants on electrical impedance and tissue response following cochlear implantation , 2007, Cochlear implants international.

[11]  Gaetano Paludetti,et al.  Residual Hearing Thresholds in Cochlear Implantation and Reimplantation , 2007, Audiology and Neurotology.

[12]  Bruce J. Gantz,et al.  Acoustic plus Electric Speech Processing: Preliminary Results of a Multicenter Clinical Trial of the Iowa/Nucleus Hybrid Implant , 2006, Audiology and Neurotology.

[13]  W. Mann,et al.  Intratympanic Dexamethasone and Hyaluronic Acid in Patients with Low-Frequency and Ménière's-Associated Sudden Sensorineural Hearing Loss , 2005, Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology.

[14]  Jan Kiefer,et al.  Hearing preservation in cochlear implantation for electric acoustic stimulation , 2004, Acta oto-laryngologica.

[15]  Jan Kiefer,et al.  Conservation of low-frequency hearing in cochlear implantation , 2004, Acta oto-laryngologica.

[16]  R. Laszig,et al.  Intracochlear insertion of electrodes using hyaluronic acid in cochlear implant surgery , 2002, The Journal of Laryngology & Otology.

[17]  S. Chandrasekhar.  Intratympanic Dexamethasone for Sudden Sensorineural Hearing Loss: Clinical and Laboratory Evaluation , 2001, Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology.

[18]  S. Chandrasekhar,et al.  Dexamethasone pharmacokinetics in the inner ear: Comparison of route of administration and use of facilitating agents , 2000 .

[19]  E. Lehnhardt.  Intracochlear electrode placement facilitated by Healon. , 1993, Advances in oto-rhino-laryngology.

[20]  N. Slepecky,et al.  A histopathological study of the inner ear after the administration of hyaluronan into the middle ear of the guinea pig. , 1987, Acta oto-laryngologica. Supplementum.