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Effect of Local Corticosteroid on Electrical Impedances after Cochlear Implantation in children: A Prospective
Kharrat Ines1, Hammami Bouthaina1, Walha Omar1
1ENT Department and Research Laboratory LR23ES01, Habib Bourguiba University Hospital, University of Sfax, Sfax, Tunisia.
Insights
Combining local and systemic corticosteroids significantly reduced electrode contact impedances early after cochlear implantation in children. This effect was more pronounced at basal electrodes but did not persist long-term.
Area of Science:
- Otolaryngology
- Neurosurgery
- Biomedical Engineering
Background:
- Cochlear implantation is a complex procedure requiring careful management of post-operative inflammation.
- Electrical impedance of electrode contacts is a critical parameter for assessing cochlear implant function.
- Corticosteroids are often used to manage inflammation, but their impact on electrode impedance requires further investigation.
Purpose of the Study:
- To evaluate the effect of combined local (intratympanic) and systemic corticosteroids on cochlear implant electrode contact impedance.
- To assess impedance changes over six months post-implantation in pediatric patients.
- To determine if the effect varies between basal and apical electrodes.
Main Methods:
- Two groups of pediatric patients undergoing cochlear implantation were studied.
- Group 1 received systemic dexamethasone; Group 2 received systemic dexamethasone plus intratympanic methylprednisolone.
- Electrical impedances were measured at multiple time points up to six months post-surgery.
Main Results:
- Impedances were significantly lower in Group 2 (combined corticosteroids) perioperatively and on post-operative day 3.
- No significant difference in impedance was observed between groups from week 1 to 6 months.
- Mean impedance at basal electrodes was significantly higher in Group 1 at 1 month.
Conclusions:
- The combination of intratympanic and intravenous corticosteroids effectively reduces electrode impedances in the early post-operative period.
- This reduction is more significant for basal electrodes.
- The protocol shows short-term efficacy in lowering impedances but lacks medium-term impact.
Objectives:
The primary aim of this study is to determine the effects of associating local and systemic corticosteroids on electrical impedance of electrode contacts during the 6 months following cochlear implantation in children. We assessed the effect of this association along the electrode array to evaluate its impact on both basal and apical electrodes.
Methods:
In 2 different patient groups, the evolution of electrical impedances was investigated during 6 months post-implantation. Children in Group 1 received systemic corticosteroids (1 ml injection of 4 mg/ml Dexamethasone (DXM) intravenously 12 hours before the procedure followed by an injection of 1 ml of 4 mg/ml de DXM during the induction of anesthesia). Group 2 received the same systemic corticosteroids with local corticosteroid (intratympanic injection [ITI] of Methylprednisolone (MP) 40 mg/1 ml given at the start of the procedure). Impedances were assessed perioperatively, on the third post-operative day, at 1 week, 1 month, 2 months, 3 months, and 6 months after implantation. We compared the mean impedance values and the average impedance at the apical and basal electrodes between both groups.
Results:
Impedances in Group 1 were significantly higher than those in Group 2, both perioperatively (P = .037) and on the third post-operative day (P = .027). Starting from the first week and throughout the 6 months post-implantation, the difference between both groups was not significant. When comparing impedances at the apical and basal electrodes between both groups, the mean impedance at the basal electrodes was significantly higher in Group 1 compared to Group 2 at 1 month (P = .042).
Conclusion:
The association of intratympanic and intravenous corticosteroids results in significantly reduced impedances during the early postoperative period. The basal electrodes have a more pronounced effect from this association. Based on these findings, this protocol is effective in lowering impedances in the short term but not in the medium term following cochlear implantation.
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