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Updated: Aug 9, 2026
Performing Repeated Intraoperative Impedance Telemetry Measurements during Cochlear Implantation
Published on: August 4, 2023
Cochlear implantation trauma and noise-induced hearing loss: Apoptosis and therapeutic strategies
Adrien A Eshraghi1, Thomas R Van de Water
1University of Miami Ear Institute, Department of Otolaryngology, University of Miami, Miller School of Medicine, Miami, Florida 33136, USA.
Abstract:
Cochlear implantation trauma and noise-induced hearing loss both involve a physical disruption of the organ of Corti and may involve several mechanisms of cell death at the molecular level, i.e., necrosis, necrosis-like programmed cell death (PCD; type 2 PCD), and apoptosis (type 1 PCD). This article reviews several promising therapeutic strategies that are currently being developed. One of these promising new strategies involves the use of a highly effective peptide inhibitor of the c-Jun N-terminal kinase cell death signal cascade (i.e., D-JNKI-1) to prevent apoptosis of injured auditory hair cells. Our recent studies showed prevention of cochlear implantation-induced hearing loss by infusing this peptide into the cochlea of guinea pigs. Another otoprotective therapy under investigation is the application of mild hypothermia to protect the cochlea from the development of a hearing loss that follows exposure to a physical trauma, e.g., electrode array insertional trauma. These forward-looking strategies have the potential of improving hearing outcomes after cochlear implantation and providing novel means of otoprotection from noise-induced trauma.
Insights
New therapies like peptide inhibitors and mild hypothermia show promise for preventing hearing loss from cochlear implants and noise exposure by protecting auditory hair cells.
Area of Science:
- Ototoxicology
- Neuroscience
- Regenerative Medicine
Background:
- Cochlear implantation trauma and noise-induced hearing loss damage the organ of Corti.
- Cell death mechanisms, including apoptosis and necrosis, are involved in hearing loss.
- Auditory hair cell protection is crucial for preserving hearing function.
Purpose of the Study:
- To review promising therapeutic strategies for preventing hearing loss.
- To investigate the efficacy of peptide inhibitors and mild hypothermia for otoprotection.
Main Methods:
- Review of current therapeutic strategies.
- In vivo studies using D-JNKI-1 peptide infusion in guinea pigs.
- Application of mild hypothermia to protect against trauma-induced hearing loss.
Main Results:
- D-JNKI-1 peptide infusion prevented hearing loss after cochlear implantation in guinea pigs.
- Mild hypothermia is being investigated as a protective therapy against physical trauma.
- These strategies target cell death pathways in auditory hair cells.
Conclusions:
- Peptide inhibitors targeting the c-Jun N-terminal kinase pathway offer a promising otoprotective strategy.
- Mild hypothermia is a potential therapeutic approach for preventing hearing loss from trauma.
- These novel strategies could significantly improve hearing outcomes and otoprotection.
