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Hear Res ; 390: 107924, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32143111

RESUMO

OBJECTIVE: To compare the difference in electrode impedance across discrete time points to 24 months post-activation for two groups of adult cochlear implant recipients, one using an investigational perimodiolar (Contour Advance®) array augmented with 40% concentration weight per weight (w/w) dexamethasone (the Drug Eluting Electrode, 'DEE' Group), and the other the commercially available Contour Advance ('Control' Group). DESIGN: Ten adult subjects were implanted with the DEE and fourteen with the Control. Electrode impedances were measured intra-operatively, one-week post-surgery, at initial activation (approximately two-weeks post-surgery), and at approximately one, three, six, 12 and 24 months post-activation. Two different impedance measurements were obtained: 1) in MP1+2 mode using Custom Sound programming software; and 2) 4-point impedance measures utilising BP+2 stimulation mode with recording on non-stimulating electrodes. Data were analysed with respect to both impedance averaged across all electrodes, and impedance for electrodes grouped into basal, middle and apical sections. RESULTS: Group mean MP1+2 impedance for the DEE was significantly lower than for the Control at all post-operative time points examined, and for each of the basal, middle and apical cochlear regions. Group mean 4-point impedance was significantly lower for the DEE than the Control in the basal region at six, 12 and 24 months post-activation and in the middle region at 12- and 24-months post-activation. The pattern of change in MP1+2 impedance differed significantly in the early post-operative period prior to device activation. A significant 4.8 kOhm reduction in impedance between surgery and one-week was observed for the DEE group but not for the Control. A 2.0 kOhm increase between the one and two week post-operative time points was observed for the Control but not for the DEE group. CONCLUSION: While rates of adoption of different surgical approaches differed between the groups and this may have had a confounding effect, the results suggest that passive elution of dexamethasone from the investigational device was associated with a change in the intracochlear environment following surgical implantation of the electrode array, as evidenced by the lower electrode impedance measures.


Assuntos
Percepção Auditiva , Implante Coclear/instrumentação , Implantes Cocleares , Dexametasona/administração & dosagem , Glucocorticoides/administração & dosagem , Perda Auditiva/reabilitação , Pessoas com Deficiência Auditiva/reabilitação , Estimulação Acústica , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Impedância Elétrica , Estimulação Elétrica , Feminino , Audição , Perda Auditiva/diagnóstico , Perda Auditiva/fisiopatologia , Perda Auditiva/psicologia , Humanos , Masculino , Pessoa de Meia-Idade , New South Wales , Pessoas com Deficiência Auditiva/psicologia , Estudos Prospectivos , Desenho de Prótese , Fatores de Tempo , Resultado do Tratamento , Vitória
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