Dexamethasone delivery for hearing preservation in animal cochlear implant model: continuity, long-term release, and fast release rate.

Background: Clinically, steroids have been used for hearing preservation both topically and systemically during cochlear implantation.Objective: This study compared steroid efficacy for hearing preservation among different types of delivery modes using an animal experiment.Materials and methods: For 76 guinea pigs, topical and systemic delivery methods, four pump types with different infusion rates, delivery durations, and total steroid amounts were used. Threshold changes of 8, 16, and 32 kHz after dummy electrode insertion were evaluated at 1 and 4 weeks and compared among delivery method and pump types. Inflammatory response in the cochlea was histologically compared.Results: For topical delivery groups, long-term release showed advantages in preserving hearing. Systemic delivery groups showed smaller threshold shifts than control group in all frequencies (p > .05). In short-term low dose application, compared to topical delivery, systemic delivery showed advantage in hearing preservation at both time point. However, others fail to show significant difference between two methods. Histologically, inflammatory response in the scala tympani at the basal turn was less in systemic delivery, especially in high dose and long-term.Conclusion and significance: The difference of hearing preservation was not obvious between two delivery methods. Higher dose and longer duration might have advantages in hearing preservation.