The Clinical Effect of Steroids for Hearing Preservation in Cochlear Implantation: Conclusions Based on Three Cochlear Implant Systems and Two Administration Regimes

Magdalena B Skarżyńska; Aleksandra Kołodziejak; Elżbieta Gos; Adam Walkowiak; Artur Lorens; Andrzej Pastuszak; Łukasz Plichta; Piotr H Skarżyński

doi:10.3390/ph15101176

The Clinical Effect of Steroids for Hearing Preservation in Cochlear Implantation: Conclusions Based on Three Cochlear Implant Systems and Two Administration Regimes

Pharmaceuticals (Basel). 2022 Sep 22;15(10):1176. doi: 10.3390/ph15101176.

Authors

Magdalena B Skarżyńska^{1

2}, Aleksandra Kołodziejak³, Elżbieta Gos³, Adam Walkowiak⁴, Artur Lorens⁴, Andrzej Pastuszak⁵, Łukasz Plichta⁵, Piotr H Skarżyński^{1

2

3

5

6}

Affiliations

¹ Institute of Sensory Organs, Mokra 1, 05-830 Kajetany, Poland.
² Center of Hearing and Speech Medincus, Mokra 7, 05-830 Kajetany, Poland.
³ World Hearing Center, Department of Teleaudiology of Hearing, Institute of Physiology and Pathology of Hearing, Mokra 17, 05-830 Kajetany, Poland.
⁴ World Hearing Center, Department of Cochlear Implants, Institute of Physiology and Pathology of Hearing, Mokra 17, 05-830 Kajetany, Poland.
⁵ World Hearing Center, Oto-Rhino-Laryngology Surgery Department, Institute of Physiology and Pathology of Hearing, 05-830 Warsaw, Poland.
⁶ Heart Failure and Cardiac Rehabilitation Department, Faculty of Medicine, Medical University of Warsaw, 03-242 Warsaw, Poland.

Abstract

The main aim of this study was to assess the clinical effect of steroids (dexamethasone and prednisone) on hearing preservation in patients who underwent cochlear implantation with different cochlear implant systems (Oticon^®, Advanced Bionics^®, Med-El^®). 147 adult patients met the inclusion criteria and were enrolled to the study and divided into three groups depending on the brand of cochlear implant they received and participated in all follow-up visits regularly. They were also randomly divided into three subgroups depending on the steroid administration regime: (1) intravenous dexamethasone (0.1 mg/kg body weight twice a day for three days); (2) combined intravenous and oral steroids (dexamethasone 0.1 mg/kg body weight twice a day plus prednisone 1 mg/kg weight once a day); and (3) no steroids (control group). The results were measured by pure tone audiometry (PTA) at three time points: (i) before implantation, (ii) at processor activation, and (iii) 12 months after activation. A hearing preservation (HP) figure was also calculated by comparing the preoperative results and the results after 12 months. Further measures collected were electrode impedance and hearing threshold in the non-operated ear. The highest HP measures (partial and complete) were obtained in the subgroups who were given steroids. Of the 102 patients given steroids, HP was partial or complete in 63 of them (62%). In comparison, partial or complete HP was achieved in only 15 patients out of 45 (33%) who were not given steroids. There were differences between the three cochlear implant groups, with the Med-El and Advanced Bionics groups performing better than the Oticon group (45% and 43% of the former two groups achieved partial or complete HP compared to 20% in the latter). Hearing thresholds in the non-operated ear were stable over 12 months. Generally, impedance was slightly lower in the 12 month follow-up in comparison with the activation period, with the exception of the Oticon group. (4) Conclusions: Pharmacological treatment with steroids in patients undergoing cochlear implantation helps to preserve residual hearing.

Keywords: cochlear implantation; dexamethasone; partial deafness treatment; prednisone; steroid administration.

Grants and funding

This research received no external funding.