The impact of dexamethasone on hearing loss in experimental pneumococcal meningitis

Bhatt, Samir M.; Cabellos, Carmen; Nadol, Joseph B.; Halpin, Chris; Lauretano, Arthur M.; Xu, Wen Z.; Tuomanen, Elaine

doi:10.1097/00006454-199502000-00002

Cited by 31 publications

(19 citation statements)

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“…In addition to surgical technique and electrode design, pharmacologic methods may be effective in reducing the inflammatory response within the inner ear [Bhatt et al, 1995;DeSautel and Brodie, 1999]. In addition, steroid administration has been demonstrated to decrease tissue damage in experimental pneumococcal meningitis [Bhatt et al, 1995;Rappaport et al, 1999] and may decrease the development of labyrinthitis ossificans secondary to bacterial labyrinthitis [Hartnick et al, 2001].…”

Section: Possible Methods To Reduce New Bone and Fibrous Tissue Formamentioning

confidence: 99%

“…In addition, steroid administration has been demonstrated to decrease tissue damage in experimental pneumococcal meningitis [Bhatt et al, 1995;Rappaport et al, 1999] and may decrease the development of labyrinthitis ossificans secondary to bacterial labyrinthitis [Hartnick et al, 2001]. The optimal treatment, including dosage, route of administration, and duration of treatment are unknown at this time.…”

Section: Possible Methods To Reduce New Bone and Fibrous Tissue Formamentioning

confidence: 99%

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Quantitative Evaluation of New Bone and Fibrous Tissue in the Cochlea following Cochlear Implantation in the Human

et al. 2007

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The formation of new bone and fibrous tissue in the human inner ear following cochlear implantation was evaluated by computer-assisted 3-D reconstruction. Seven temporal bones from patients who in life had undergone cochlear implantation were prepared for histological study with the implant in situ. The specimens were sectioned in the axial plane at a thickness of 20 µm. At least every tenth section was digitally reconstructed in three dimensions and volumes of new bone and fibrous tissue were calculated per millimeter length of the cochlea. New bone and fibrous tissue were found in all seven specimens, particularly at the cochleostomy site. In addition, new bone and fibrous tissue had extended to variable lengths along the track of the cochlear implant and in some cases extended beyond the distal end of the implanted electrode. This methodology provides a quantitative tool for evaluation of new bone and fibrous tissue in the inner ear following implantation. This should assist in correlating psychophysical and speech perception tests with intracochlear pathology, evaluating both electrode design and the techniques of preserving residual auditory function.

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Section: Possible Methods To Reduce New Bone and Fibrous Tissue Formamentioning

confidence: 99%

Section: Possible Methods To Reduce New Bone and Fibrous Tissue Formamentioning

confidence: 99%

Quantitative Evaluation of New Bone and Fibrous Tissue in the Cochlea following Cochlear Implantation in the Human

et al. 2007

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“…Many studies have shown, that administration of dexamethasone before or with the initiation of antibiotic therapy improves the mortality and incidence of sequelae of bacterial meningitis in children, including hearing loss [89][90][91]. Furthermore, dexamethasone reduced the degree of hearing loss in some animal models of meningitis [92,93]. In adults, the use of steroids has been heavily discussed and several studies have produced conflicting results [94,95].…”

Section: Promising Adjunctive Treatment Optionsmentioning

confidence: 99%

Nitrogen and Oxygen Molecules in Meningitis-Associated Labyrinthitis and Hearing Impairment

et al. 2007

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Pneumococcal meningitis remains a serious disease with a case fatality rate of 15%-25%. Furthermore, long-term residues affect up to 50% of survivors. One of the most frequent sequelae is sensorineural hearing loss, which occurs in 26% of survivors of pneumococcal meningitis. Unfortunately, sufficient treatment regimens are still missing. New insights into the pathology and pathophysiology of meningitis-associated hearing loss have come from animal models of bacterial meningitis. Most likely, bacteria reach the cochlea through the cochlear aquaeduct. Once arrived in the perilymphatic spaces, they induce a severe suppurative labyrinthitis. The blood-labyrinth barrier breaks, hair cells are damaged, and neurons in the spiral ganglion undergo cell death, leading to meningitis-associated hearing loss. Reactive oxygen and nitrogen species, in particular peroxynitrite, seem to be among the crucial mediators of cochlear damage and hearing loss during meningitis. In our rat model of pneumococcal meningitis, adjunctive therapy with the antioxidants and peroxynitrite scavengers Mn(III)tetrakis(4-bencoic acid)-porphyrin (MnTBAP) and N-Acetyl-L-Cystein (NAC) significantly attenuated acute and long-term hearing loss. In several other animal studies of pneumococcal meningitis, adjunctive antioxidant therapy also protected infected animals from intracranial complications. Therefore, the use of antioxidants seems to be a promising future treatment option in pneumococcal meningitis.

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“…Recent literature has suggested that the vigorous host immune response to the infecting organisms is responsible for much of the morbidity produced by bacterial meningitis, including sensorineural hearing loss [1,[4][5][6][7]. These circumstances have contributed to controversy regarding optimal adjunctive therapy to decrease this morbidity.…”

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confidence: 99%

Prevention of Hearing Loss in Experimental Pneumococcal Meningitis by Administration of Dexamethasone and Ketorolac

et al. 1999

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Pneumococcal meningitis remains a significant cause of morbidity, particularly sensorineural hearing loss. Recent literature has suggested that a vigorous host immune response to Streptococcus [corrected] pneumoniae is responsible for much of the neurologic sequelae, including deafness, after bacterial meningitis. This study used a rabbit model of hearing loss in experimental pneumococcal meningitis to evaluate the therapeutic effect of two anti-inflammatory agents, dexamethasone and ketorolac, coadministered with ampicillin. Both adjunctive drugs minimized or prevented sensorineural hearing loss compared with placebo. Dexamethasone, administered 10 min before ampicillin, was particularly effective in minimizing mean hearing threshold change compared with placebo for both clicks (dexamethasone: 6.7-dB sound pressure level [SPL] vs. placebo: 33. 4-dB SPL, P=.0078) and 10-kHz tone bursts (dexamethasone: 8.4-dB SPL vs. placebo: 53.4-dB SPL, P=.0003). These findings support the beneficial role of anti-inflammatory agents in reducing the incidence of hearing loss from pneumococcal meningitis, especially if therapy is instituted early in the course of infection.

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The impact of dexamethasone on hearing loss in experimental pneumococcal meningitis

Cited by 31 publications

References 0 publications

Quantitative Evaluation of New Bone and Fibrous Tissue in the Cochlea following Cochlear Implantation in the Human

Quantitative Evaluation of New Bone and Fibrous Tissue in the Cochlea following Cochlear Implantation in the Human

Nitrogen and Oxygen Molecules in Meningitis-Associated Labyrinthitis and Hearing Impairment

Prevention of Hearing Loss in Experimental Pneumococcal Meningitis by Administration of Dexamethasone and Ketorolac

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