Cochlear implantation: an opportunity for drug development.

For many years, the fields of inner ear pharmacology and hearing devices have progressed in parallel with limited interaction. Recently, there has been a considerable advancement in our understanding of the inner ear and its pathologies. Cochlear implantation is now being adapted for patients with considerable residual hearing but minimal benefit from hearing aids. A major consequence is the recognition that devices can be implanted into the partially deaf inner ear with minimal loss of hearing. This opens the door to the concept of local drug treatment of the inner ear using implantable devices. The evolution of cochlear implantation thus presents us with an opportunity to develop a range of local pharmacologic interventions to prevent hearing degeneration.