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术中应用糖皮质激素水凝胶对豚鼠人工耳蜗植入模型残余听力及异物反应的影响

Effects of intraoperatively applied glucocorticoid hydrogels on residual hearing and foreign body reaction in a guinea pig model of cochlear implantation.

作者信息

Honeder Clemens, Landegger Lukas David, Engleder Elisabeth, Gabor Franz, Plasenzotti Roberto, Plenk Hanns, Kaider Alexandra, Hirtler Lena, Gstoettner Wolfgang, Arnoldner Christoph

机构信息

Department of Otorhinolaryngology, Medical University of Vienna.

出版信息

Acta Otolaryngol. 2015 Apr;135(4):313-9. doi: 10.3109/00016489.2014.986758. Epub 2015 Feb 26.

Abstract

CONCLUSION

The intraoperative application of glucocorticoid-loaded hydrogels seems to cause a reduction in neutrophil infiltration. No beneficial effect on hearing thresholds was detected.

OBJECTIVES

To evaluate the application of dexamethasone- and triamcinolone acetonide-loaded hydrogels for effects on hearing preservation and foreign body reaction in a guinea pig model for cochlear implantation (CI).

METHODS

A total of 48 guinea pigs (n = 12 per group) were implanted with a single channel electrode and intraoperatively treated with 50 μl of a 20% w/v poloxamer 407 hydrogel loaded with 6% dexamethasone or 30% triamcinolone acetonide, a control hydrogel, or physiological saline. Click- and tone burst-evoked compound action potential thresholds were determined preoperatively and directly postoperatively as well as on days 3, 7, 14, 21, and 28. At the end of the experiment, temporal bones were prepared for histological evaluation by a grinding/polishing technique with the electrode in situ. Three ears per treatment group were serially sectioned and evaluated for histological alterations.

RESULTS

The intratympanic application of glucocorticoid-loaded hydrogels did not improve the preservation of residual hearing in this cochlear implant model. The foreign body reaction to the electrode appeared reduced in the glucocorticoid-treated animals. No correlation was found between the histologically described trauma to the inner ear and the resulting hearing threshold shifts.

摘要

结论

术中应用负载糖皮质激素的水凝胶似乎可减少中性粒细胞浸润。未检测到对听力阈值有有益影响。

目的

在豚鼠人工耳蜗植入(CI)模型中,评估负载地塞米松和曲安奈德的水凝胶对听力保留和异物反应的作用。

方法

总共48只豚鼠(每组n = 12只)植入单通道电极,并在术中用50 μl负载6%地塞米松或30%曲安奈德的20% w/v泊洛沙姆407水凝胶、对照水凝胶或生理盐水进行处理。术前、术后即刻以及术后第3、7、14、21和28天测定短声和短纯音诱发的复合动作电位阈值。实验结束时,采用研磨/抛光技术制备颞骨,电极原位保留,用于组织学评估。每个治疗组取三只耳朵进行连续切片,评估组织学改变。

结果

在该人工耳蜗植入模型中,鼓室内应用负载糖皮质激素的水凝胶并未改善残余听力的保留情况。糖皮质激素治疗的动物对电极的异物反应似乎有所减轻。在内耳组织学描述的创伤与由此产生的听力阈值变化之间未发现相关性。

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