Abstract
Preservation of residual hearing after cochlear implant is an important issue with regards to hearing performance. Various methods of steroid administration have been widely used in clinical practice to reduce inflammation and preserve residual hearing. Here we compare the effect of different routes of dexamethasone administration on intracochlear inflammation and residual hearing in guinea pig ears. Dexamethasone was delivered into the guinea pigs either through intracochlear, intratympanic or systemic route. The intracochlear concentration of dexamethasone, residual hearing, inflammatory cytokines and histopathologic changes were evaluated over time. A higher intracochlear dexamethasone concentration was observed after intracochlear administration than through the other routes. Residual hearing was better preserved with local dexamethasone administration as was supported by the reduced inflammatory cytokines, more hair cell survival and less severe intracochlear fibrosis and ossification concurrently seen in the local delivery group than in the systemic group. The results demonstrate that local dexamethasone delivery can reduce intracochlear inflammation and preserve residual hearing better than in systemically administered dexamethasone.
Highlights
Dexamethasone is a widely used steroid that has potent anti-inflammatory effect
Eighty-four animals were used for the experimental group with bilateral cochleostomy and this experimental group was divided into cochleostomy only group (CS), intracochlear dexamethasone group (IC), intratympanic dexamethasone group (IT) and intraperitoneal dexamethasone group (IP)
In the IC group, the differences were significant with 4, 16, 32 kHz and click at 1 month after surgery and all measured frequencies at 2 months after surgery compared to CS group (p
Summary
Dexamethasone is a widely used steroid that has potent anti-inflammatory effect. Steroid is the treatment of choice for idiopathic sudden sensorineural hearing loss[1,2,3] and has been regarded as having a role in the preservation of residual hearing in cochlear implant surgery [4,5,6]. Effects of dexamethasone on intracochlear inflammation or locally. Several reports have shown that dexamethasone, whether applied locally[9,10,11,12,13] or systemically[5, 14, 15], was able to significantly reduced hearing loss. It is still questionable whether systemic or intratympanic injected steroid can penetrate the cochlea effectively. We aimed to compare the effects of dexamethasone administered via different routes on intracochlear inflammation and residual hearing after cochleostomy
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