Local delivery of steroids to inner ear via medical device INCAT (the Inner Ear Catheter) in partial deafness patients during cochlear implantation - preliminary results and a feasibility study.
Magdalena B Skarżyńska, Elżbieta Gos, Piotr H Skarżyński, Artur Lorens, Adam Walkowiak, Henryk Skarżyński
Author Information
Magdalena B Skarżyńska: Scientific Department, Institute of Sensory Organs, Kajetany, Poland.
Elżbieta Gos: World Hearing Center, Department of Teleaudiology of Hearing, Institute of Physiology and Pathology of Hearing, Kajetany, Poland.
Piotr H Skarżyński: Scientific Department, Institute of Sensory Organs, Kajetany, Poland.
Artur Lorens: World Hearing Center, Department of Cochlear Implants, Institute of Physiology and Pathology of Hearing, Kajetany, Poland.
Adam Walkowiak: World Hearing Center, Department of Cochlear Implants, Institute of Physiology and Pathology of Hearing, Kajetany, Poland.
Henryk Skarżyński: World Hearing Center, Oto-Rhino-Laryngology Surgery Department, Institute of Physiology and Pathology of Hearing, Warsaw, Poland.
BACKGROUND: The primary aim was to assess the effectiveness and safety of three different algorithms of using steroids and inner ear catheter (INCAT) MED-EL® in partial deafness patients who underwent cochlear implantation. The secondary goal was the assessment of the impact of the depth of INCAT on hearing preservation after cochlear implantation. RESEARCH DESIGN AND METHODS: There were three algorithms of steroid administration: 1) methylprednisolone 62.5 mg/ml (solution), 3 patients; 2) methylprednisolone 40 mg/ml (suspension), 4 patients; 3) dexamethasone 4 mg/ml (solution), 3 patients. Pure tone audiometry (0.125-8 kHz) was performed preoperatively, 1 and 6 months post-op. Hearing preservation was assessed according to the HEARRING group formula. Impedance measurements were taken at two days, 1 and 6 months after surgery. RESULTS: Patients treated with methylprednisolone 40 mg/ml in suspension showed the best hearing preservation (50% complete and 50% partial preservation) 1 month post-op and later remained the most favorable. The lowest impedance was found in this group both 1 and 6 months post-op. A shorter INCAT insertion depth appeared to be more favorable than a longer one. CONCLUSION: Our results suggest that patients treated with methylprednisolone 40 mg/ml (suspension) had better hearing outcomes compared to the other two medications.
