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Immune Response After Cochlear Implantation.
Frontiers in Neurology ( IF 3.4 ) Pub Date : 2020-05-14 , DOI: 10.3389/fneur.2020.00341
Edi Simoni 1, 2, 3 , Erica Gentilin 1, 2 , Mariarita Candito 1, 2 , Giulia Borile 4, 5 , Filippo Romanato 4, 5 , Milvia Chicca 6 , Sara Nordio 7 , Marta Aspidistria 8 , Alessandro Martini 1, 2 , Diego Cazzador 1, 2, 3 , Laura Astolfi 1, 2
Affiliation  

A cochlear implant (CI) is an electronic device that enables hearing recovery in patients with severe to profound hearing loss. Although CIs are a successful treatment for profound hearing impairment, their effectivity may be improved by reducing damages associated with insertion of electrodes in the cochlea, thus preserving residual hearing ability. Inner ear trauma leads to inflammatory reactions altering cochlear homeostasis and reducing post-operative audiological performances and electroacoustic stimulation. Strategies to preserve residual hearing ability led to the development of medicated devices to minimize CI-induced cochlear injury. Dexamethasone-eluting electrodes recently showed positive outcomes. In previous studies by our research group, intratympanic release of dexamethasone for 14 days was able to preserve residual hearing from CI insertion trauma in a Guinea pig model. Long-term effects of dexamethasone-eluting electrodes were therefore evaluated in the same animal model. Seven Guinea pigs were bilaterally implanted with medicated rods and four were implanted with non-eluting ones. Hearing threshold audiograms were acquired prior to implantation and up to 60 days by recording compound action potentials. For each sample, we examined the amount of bone and fibrous connective tissue grown within the scala tympani in the basal turn of the cochlea, the cochleostomy healing, the neuronal density, and the correlation between electrophysiological parameters and histological results. Detection of tumor necrosis factor alpha, interleukin-6, and foreign body giant cells showed that long-term electrode implantation was not associated with an ongoing inflammation. Growth of bone and fibrous connective tissue around rods induced by CI was reduced in the scala tympani by dexamethasone release. For cochleostomy sealing, dexamethasone-treated animals showed less bone tissue growth than negative. Dexamethasone did not affect cell density in the spiral ganglion. Overall, these results support the use of dexamethasone as anti-inflammatory additive for eluting electrodes able to protect the cochlea from CI insertion trauma.

中文翻译:

人工耳蜗植入后的免疫反应。

人工耳蜗(CI)是一种电子设备,可以使重度至重度听力损失的患者恢复听力。尽管CI是治疗严重听力障碍的成功方法,但可以通过减少与在耳蜗中插入电极相关的损害来改善其有效性,从而保留残余的听力。内耳创伤会导致炎症反应,从而改变耳蜗的稳态,并降低术后听力学表现和电声刺激。保留残余听力的策略导致开发了药物设备,以最大程度地减少CI引起的耳蜗损伤。地塞米松洗脱电极最近显示出积极的结果。在我们研究小组的先前研究中,在豚鼠模型中,鼓膜内释放地塞米松14天能够保留CI插入创伤引起的残留听力。因此,在同一动物模型中评估了地塞米松洗脱电极的长期作用。七只豚鼠被双边植入了药棒,四只被植入了非洗脱猪。通过记录复合动作电位,在植入之前和长达60天之内获取听力阈值听力图。对于每个样本,我们检查了在耳蜗基底转弯,鼓膜切开愈合,神经元密度以及电生理参数与组织学结果之间的相关性时,在鼓sc内生长的骨和纤维结缔组织的数量。检测肿瘤坏死因子α,白介素6,异物巨细胞表明长期的电极植入与持续的炎症无关。CI引起的杆周围骨和纤维结缔组织的生长通过地塞米松的释放而减少了鼓室结膜。进行耳蜗切开术密封时,地塞米松治疗的动物的骨组织生长少于阴性。地塞米松不影响螺旋神经节中的细胞密度。总体而言,这些结果支持地塞米松作为抗炎添加剂用于洗脱能够保护耳蜗免受CI插入损伤的电极。地塞米松治疗的动物的骨组织生长少于阴性。地塞米松不影响螺旋神经节中的细胞密度。总体而言,这些结果支持地塞米松作为抗炎添加剂用于洗脱能够保护耳蜗免受CI插入损伤的电极。地塞米松治疗的动物的骨组织生长少于阴性。地塞米松不影响螺旋神经节中的细胞密度。总体而言,这些结果支持地塞米松作为抗炎添加剂用于洗脱能够保护耳蜗免受CI插入损伤的电极。
更新日期:2020-05-14
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