The Role of Preoperative Steroids in Atraumatic Cochlear Implantation Surgery

Lo, Jonathon; Campbell, Luke; Sale, Phillip; Chambers, Scott; Hampson, Amy; Eastwood, Hayden; O’Leary, Stephen

doi:10.1097/mao.0000000000001505

Cited by 26 publications

(16 citation statements)

References 41 publications

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“…In the 1990s and into this century, the first steps toward "soft surgery" in cochlear implantation began to be implemented (6,11,12). Now the use of soft electrodes, a round window approach (RWA), reduced insertion angles, and use of perioperative steroids has become widespread and has proven to be effective in preserving the cochlear structure (13)(14)(15). However, the question of how protective these measures are on the vestibule still remains unanswered.…”

Section: Introductionmentioning

confidence: 99%

Vestibular Function After Cochlear Implantation in Partial Deafness Treatment

et al. 2021

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Introduction: Cochlear implantation is a fully accepted method of treating individuals with profound hearing loss. Since the indications for cochlear implantation have broadened and include patients with low-frequency residual hearing, single-sided deafness, or an already implanted ear (meaning bilateral cochlear implantation), the emphasis now needs to be on vestibular protection.Materials and Methods: The research group was made up of 107 patients operated on in the otorhinolaryngosurgery department: 59 females and 48 males, aged 10.4–80.2 years (M = 44.4; SD = 18.4) with hearing loss lasting from 1.4 to 56 years (M = 22.7; SD = 13.5). The patients underwent cVEMP, oVEMP, a caloric test, and vHIT assessment preoperatively, and, postoperatively, cVEMP and oVEMP at 1–3 months and a caloric test and vHIT at 4–6 months.Results: After cochlear implantation, there was postoperative loss of cVEMP in 19.2% of the patients, oVEMP in 17.4%, reduction of caloric response in 11.6%, and postoperative destruction of the lateral, anterior, and posterior semicircular canal as measured with vHIT in 7.1, 3.9, and 4% respectively.Conclusions: Hearing preservation techniques in cochlear implantation are connected with vestibular protection, but the risk of vestibular damage in never totally eliminated. The vestibular preservation is associated with hearing preservation and the relation is statistically significant. Informed consent for cochlear implantation must include information about possible vestibular damage. Since the risk of vestibular damage is appreciable, preoperative otoneurological diagnostics need to be conducted in the following situations: qualification for a second implant, after otosurgery (especially if the opposite ear is to be implanted), having a history of vestibular complaints, and when there are no strict audiological or anatomical indications on which side to operate.

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Section: Introductionmentioning

confidence: 99%

Vestibular Function After Cochlear Implantation in Partial Deafness Treatment

et al. 2021

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“…Many experimental studies in animals have demonstrated that the use of corticosteroids is able to preserve hearing thresholds, increase the survival of hair cells and spiral ganglia, and decrease the formation of new fibrotic tissue within implanted cochlea (20)(21)(22)(23)(24)(25)(26)(27). Clinical studies demonstrate lower impedances and improved preservation of low-frequency residual hearing in patients when corticosteroids are used in CI surgery (28)(29)(30)(31)(32)(33)(34).…”

Section: Introductionmentioning

confidence: 99%

“…Results of clinical pilot studies considering pure tone audiometry or electrode impedance measurement showed a slight tendency in favor for local application but only included few patients (32,33). Additionally, a prolonged application after insertion seems to be more effective in suppressing adverse effects than single-shot glucocorticoid application prior to insertion of the cochlear implant electrode (22)(23)(24)(25)(26)(27). In a guinea pig model of insertion trauma, the measurements of inflammatory cytokines in perilymph revealed that suppression of inflammation is most successful when glucocorticoids are applied intracochlearly (26).…”

Section: Introductionmentioning

confidence: 99%

Long-Term in vivo Release Profile of Dexamethasone-Loaded Silicone Rods Implanted Into the Cochlea of Guinea Pigs

et al. 2020

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“…It is used in the treatment of diseases such as asthma, arthritis, adrenal insufficiency or chronic obstructive pulmonary disease. In the field of otorhinolaryngology, dexamethasone and other glucocorticoids (e.g., prednisone, methylprednisolone) are used in the treatment of severe and chronic diseases, such as partial deafness, Meniere's disease or autoimmune diseases [16,17].…”

Section: Introductionmentioning

confidence: 99%

The Clinical Effects of Steroids Therapy in the Preserving Residual Hearing after Cochlear Implantation with the OTICON Neuro Zti EVO

Skarżyńska

Kołodziejak

Gos

et al. 2021

JCM

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Background: A prospective clinical study was conducted to investigate whether two different pharmacotherapy strategies of steroid administration impact hearing preservation in adult patients who underwent cochlear implantation with the Oticon Medical Neuro cochlear implant system. Methods: Twenty nine adult participants were included. Pure tone audiometry was performed before implantation, during processor activation and 12 months after activation. There were three treatment groups: (1) intravenous steroid therapy (standard steroid therapy with dexamethasone administrated intravenously at the dose 0.1 mg/kg body mass twice a day); (2) combined oral and intravenous steroid therapy (extended steroid therapy with dexamethasone administrated intravenously at the dose 0.1 mg/kg b.m. twice a day and prednisone (orally) at the dose 1 mg/kg body mass/24 h), and (3) no steroid therapy (a control group). Patients’ hearing thresholds before implantation were on average 103 dB HL, 89 dB HL, and 93 dB HL, respectively. Results: Deterioration of hearing thresholds was observed in all three patients’ groups. Twelve months after surgery the patients with and without steroid therapy had similar hearing thresholds. Conclusions: The steroid regimen used in this study did not play a significant role in patients with non-functional residual hearing, who underwent cochlear implantation with the Oticon Medical Neuro cochlear implant system.

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The Role of Preoperative Steroids in Atraumatic Cochlear Implantation Surgery

Cited by 26 publications

References 41 publications

Vestibular Function After Cochlear Implantation in Partial Deafness Treatment

Vestibular Function After Cochlear Implantation in Partial Deafness Treatment

Long-Term in vivo Release Profile of Dexamethasone-Loaded Silicone Rods Implanted Into the Cochlea of Guinea Pigs

The Clinical Effects of Steroids Therapy in the Preserving Residual Hearing after Cochlear Implantation with the OTICON Neuro Zti EVO

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