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Scientific Oral Presentations

Otology/Neurotology

Session: Scientific Oral Presentations 6 - Otology/Neurotology

Intracochlear Drug Delivery Using Catheter and Dexamethasone Eluting Electrode Preserves Residual Hearing Post Cochlear Implantation

Monday, September 30, 2024
9:54 AM – 10:00 AM EDT
Location: MBCC, 231
Disclosure(s):
Maria-Pia Tuset, MD, MSc:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Jaimee N. Cooper, BS:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Jeenu Mittal, MSc:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Keelin A. McKenna, MS:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Adrien A. Eshraghi, MD, MSc:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: Delivering drugs intracochlearly is highly challenging, especially achieving elevated perilymphatic drug levels through the cochlea. This study aimed to assess the feasibility and safety of a cochlear catheter (canula) on inner ear drug delivery. Secondary goals included evaluating effectiveness of drug A administered via the canula in preserving residual hearing and investigating the molecular mechanisms involved in otoprotection.

Methods: Animals were divided into 10 groups: Control; Implantation with a cochlear implant (CI); Implantation with a dexamethasone eluting CI (Dexel); Canula elution of artificial perilymph (Can + AP); Canula elution of Ringer lactate (Can + RL); Canula elution of RL and CI (Can + CI); Canula elution of RL and Dexel (Can + Dexel); Canula elution of drug A at 2mM (CanA2); Canula elution of drug A 2mM and CI (CanA2+ CI); Canula elution of drug A 2mM and Dexel (CanA2+ Dexel). Hearing thresholds were determined preoperatively, at day 7 and day 30 post-cochlear implantation, using auditory brainstem responses (ABRs). Organ of Corti dissections were performed at day 30 for hair cell (HC) viability and oxidative stress assessment using immunostaining.

Results: CanA2+Dexel group had significantly lower hearing thresholds compared to standard CI group, CanA2 group, and Dexel group, and was the only group with shifts similar to controls. Can+CI group presented similar hair cell viability compared to standard CI group for basal turn OHCs. OHC viability was significantly higher to standard CI and similar to controls in group CanA2+Dexel in all turns (99% vs 19% apical turn, 44% middle turn, 75% apical turn, p < 0.0001). HNE signal intensity was similar to control in CanA2+ Dexel.

Conclusions: Canula effusion can be used to deliver pharmaceutical interventions along with dexamethasone eluting CI without affecting its efficacy. Drug A presents strong anti-apoptotic potential, and administration through the canula together with Dexel implantation achieves a synergistic effect and provides enhanced otoprotection.

    Presenting Author(s)

  • Maria-Pia Tuset, MD, MSc

    Research Fellow/ENT-Head and Neck Surgeon Paris
    Hearing Research and Cochlear Implant Laboratory, Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, Florida, USA/ ENT-Head and Neck Surgery Department, Fondation Adolphe de Rothschild Hospital , Paris, FRANCE
    Paris, Ile-de-France, France

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

    • Co-Author(s)

  • Jaimee N. Cooper, BS

    Medical Student
    Hearing Research and Cochlear Implant Laboratory, Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, Florida, USA
    Fort Lauderdale, Florida, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

  • DE

    Dario Ebode, MD

    Hearing Research and Cochlear Implant Laboratory, Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, Florida, USA, United States

    Disclosure information not submitted.

  • JM

    Jeenu Mittal, MSc

    Ms
    University of Miami
    Miami, FL, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

  • CG

    Carolyn Garnham

    Med-El, Innsbruck, Austria, United States

    Disclosure information not submitted.

  • TM

    Teresa Melchionna

    Med-El, Innsbruck, Austria, United States

    Disclosure information not submitted.

  • SS

    Soren Schlip

    Med-El, Innsbruck, Austria, United States

    Disclosure information not submitted.

  • DG

    Dimitri Godur

    Hearing Research and Cochlear Implant Laboratory, Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, Florida, USA, United States

    Disclosure information not submitted.

  • Keelin A. McKenna, MS

    Medical Student
    Hearing Research and Cochlear Implant Laboratory, Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, Florida, USA
    Miami, Florida, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

  • RM

    Rahul Mittal, PhD

    Hearing Research and Cochlear Implant Laboratory, Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, Florida, USA, United States

    Disclosure information not submitted.

    • Senior Author(s)

  • Adrien A. Eshraghi, MD, MSc

    Professor of Otolaryngology, Neurosurgery, and Pediatrics
    University of Miami
    Miami, Florida, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.