Abstract
Background: Electrode insertion trauma (EIT) during cochlear implantation (CI) can cause loss of residual hearing. L-N-acetylcysteine (L-NAC) and dexamethasone (Dex) have been individually shown to provide otoprotection albeit at higher concentrations that may be associated with adverse effects. Objective/Aims: The aim of this study is to determine whether L-NAC and Dex could be combined to decrease their effective dosage. Materials and Methods: The organ of Corti (OC) explants were divided into various groups: 1) control; 2) EIT; 3) EIT treated with different concentrations of Dex; 4) EIT treated with different concentrations of L-NAC; 5) EIT treated with L-NAC and Dex in combination. Hair cell (HC) density, levels of oxidative stress, proinflammatory cytokines and nitric oxide (NO) was determined. Results: There was a significant loss of HCs in explants subjected to EIT compared to the control group. L-NAC and Dex in combination was able to provide significant otoprotection at lower concentrations compared to individual drugs. Conclusions and Significance: A combination containing L-NAC and Dex is effective in protecting sensory cells at lower protective doses than each compound separately. These compounds can be combined allowing a decrease of potential side effects of each compound and providing significant otoprotection for EIT.
Highlights
Cochlear implantations (CIs) have provided multiple benefits for patients, resulting in expanding indications over the years, in both adult and pediatric patients mainly with bilateral severe-to-profound sensorineural hearing loss [1,2]
CIs represent the current standard of care for auditory rehabilitation, reestablishing the function of the inner hair cells by converting the acoustic signal to electrical stimuli for activation of cochlear nerve fibers [3]
Improvement in speech processor and electrode technologies have helped these children to succeed in conventional classrooms
Summary
Cochlear implantations (CIs) have provided multiple benefits for patients, resulting in expanding indications over the years, in both adult and pediatric patients mainly with bilateral severe-to-profound sensorineural hearing loss [1,2]. Hearing-impaired patients that previously used appropriate hearing aids with adequate amplification but little to no useful benefit can take advantage of CI technology, as positive outcomes from the procedure far outweigh the risks These findings have led to higher motivation and realistic expectations from patients and their families. Conclusions and Significance: A combination containing L-NAC and Dex is effective in protecting sensory cells at lower protective doses than each compound separately.
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