A novel combination of drug therapy to protect residual hearing post cochlear implant surgery.

ConclusionsA cocktail combining NAC, Mannitol, and Dexamethasone may be used to prevent loss of residual hearing post-implantation. There is a window of opportunity to treat the cochlea before the onset of cell death in HCs.ObjectiveInner ear trauma caused by cochlear implant electrode insertion tra...

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Publicado en:Acta Oto-Laryngologica Vol. 136; no. 4; pp. 420 - 425
Autores principales: Eshraghi, Adrien A., Roell, Jonathan, Shaikh, Noah, Telischi, Fred F., Bauer, Blake, Guardiola, Mateo, Bas, Esperanza, Van De Water, Thomas, Rivera, Ileana, Mittal, Jeenu
Formato: pictorial research tables/charts Journal Article
Publicado: Taylor & Francis Ltd Apr2016
Acceso en línea:Ver este registro en EBSCOhost
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      pub: Taylor & Francis Ltd
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        10.3109/00016489.2015.1134809
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        atl: A novel combination of drug therapy to protect residual hearing post cochlear implant surgery.
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        au:
          Eshraghi, Adrien A.
          Roell, Jonathan
          Shaikh, Noah
          Telischi, Fred F.
          Bauer, Blake
          Guardiola, Mateo
          Bas, Esperanza
          Van De Water, Thomas
          Rivera, Ileana
          Mittal, Jeenu
        affil: Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, FL, USA
      sug:
        subj:
          Drug Therapy, Combination
          Cochlear Implant
          Hearing Disorders Prevention and Control
          Hearing Disorders Drug Therapy
          Postoperative Care
          Mannitol Administration and Dosage
          Dexamethasone Administration and Dosage
          Acetylcysteine Administration and Dosage
          Animal Studies
          Rats
          Tissue Culture Techniques
          In Vitro Studies
          Models, Biological
          Hair Cells Drug Effects
          Staining and Labeling
          Reactive Oxygen Species
          Microscopy Methods
          Descriptive Statistics
          Data Analysis Software
      ab: ConclusionsA cocktail combining NAC, Mannitol, and Dexamethasone may be used to prevent loss of residual hearing post-implantation. There is a window of opportunity to treat the cochlea before the onset of cell death in HCs.ObjectiveInner ear trauma caused by cochlear implant electrode insertion trauma (EIT) initiates multiple molecular mechanisms in hair cells (HCs) or support cells (SCs), resulting in initiation of programmed cell death within the damaged tissues of the cochlea, which leads to loss of residual hearing. In earlier studies L-N-acetylcysteine (L-NAC), Mannitol, and dexamethasone have been shown independently to protect the HCs loss against different types of inner ear trauma. These three molecules have different otoprotective effects. The goal of this preliminary study is to test the efficacy of a combination of these molecules to enhance the otoprotection of HCs against EIT.MethodsOC explants were dissected from P-3 rats and placed in serum-free media. Explants were divided into control and experimental groups. Control group: (1) untreated controls; (2) EIT. Experimental group: (1) EIT + L-NAC (5, 2, or 1 mM); (2) EIT + Mannitol (100, 50, or 10 mM); (3) EIT + Dex (20, 10, or 5 μg/mL); (4) EIT + L-NAC + Mannitol + Dex. After EIT was caused in anin-vitromodel of CI, explants were cultured in media containing L-NAC alone, Mannitol alone, or Dex alone at decreasing concentrations. Concentrations of L-NAC, Mannitol, and Dex that showed 50% protection of hair cell loss individually were used as a combination in experimental group 4.ResultsThere was an increase of total hair cell (THC) loss in the EIT OC explants when compared with control group HC counts or the tri-therapy cochlea. This study defined the dosage of L-NAC, Mannitol, and Dex for the survival of 50% protection of hair cellsin vitro. Their combination provided close to 96% protection, demonstrating an additive effect.
      pubtype: Academic Journal
      doctype:
        pictorial
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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