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- Title
The clinical effect of steroids in preservation of hearing in patients who underwent cochlear implantation.
- Authors
B., Skarżyńska M.; A., Kołodziejak; E., Gos; Skarżyński
- Abstract
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 three different cochlear implants (Oticon Medical Neuro cochlear implant system, Advanced Bionics HiRes Ultra 3D and Med-El cochlear system). Methods: 100 adult participants were included. Pure tone audiometry was performed before implantation, during processor activation (in one subgroup between activation and 12 month after activation as well) 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). Hearing preservation was established by pure tone audiometry based on the pre-operative and postoperative average hearing thresholds according to the formula developed by the HEARRING Network. Non-parametric test were used in statistical analysis. Results: Deterioration of hearing thresholds was observed in all patients' groups. In the Advanced Bionics group, majority of the patients in the intravenous study group had hearing preserved partially (77.8%). The similar was observed in the combination of steroid therapy (partial hearing preservation was found in 61.5% of the participants). The opposite was true in the subgroup without steroid therapy, most controls (38.5%) had no measurable hearing 12 months after activation. Patients with combined oral and IV steroid therapy (prolonged steroid therapy) had better results when compared with patients with intravenous (IV) steroid therapy (standard steroid therapy) and the control group. In the Oticon group, twelve months after surgery the patients with and without steroid therapy had similar hearing thresholds. In the Med-El group, patients with combined oral and IV steroid therapy (prolonged steroid therapy) had better results when compared with patients with intravenous (IV) steroid therapy (standard steroid therapy) and the control group. Conclusions: The steroid regimen used in this study may be beneficial in preservation of residual hearing with the type of implantation, surgical skills and initial conditions of patients. Patients with steroid therapy gained higher scores in hearing preservation.
- Subjects
POLAND; STEROID drugs; HEARING; COCHLEAR implants; CLINICAL trials; SURGERY; PATIENTS; CONFERENCES &; conventions; TREATMENT effectiveness
- Publication
Journal of Hearing Science, 2022, Vol 12, Issue 1, p194
- ISSN
2083-389X
- Publication type
Article