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Cochlear Implants may Consequently Drive Hearing Loss

Cochlear Implants may Consequently Drive Hearing Loss

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Highlights:
  • Clinical advancements have enabled the ready availability of cochlear implantation to aid hearing loss
  • However, the technical advancements have also provided insights into the negative impacts of cochlear implants
  • New bone formation after the cochlear implants may adversely affect the hearing loss
The development of new bone formation after the cochlear implants may adversely increase the long-term hearing loss as per a study in Radiological Society of North America, published in Radiology.
Clinical advancements and surgical techniques have enabled for ready availability of cochlear implantation to aid hearing loss. This, in turn, also urges for novel monitoring and detecting techniques for complications like new bone formation arising due to it.

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Cochlear Implantations Aid Hearing

Cochlear implantations are established as one of the potent ways to manage severe hearing loss. Although the device does not restore normal hearing, they aid in better recognition and understanding of the speech.

The device has two parts:
  • An external part - sits behind the ear
  • Second part - surgically implanted beneath the skin to stimulate the cochlear nerves
Cochlear nerves are the spiral, fluid-filled structures present in the inner ear for transmitting the sound across sensory nerves to the brain.

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Complication of Cochlear Implants

The complications arising from cochlear implants are reported to be quite rare. However, studies have revealed incidences of problems like fibrosis, inflammation, and even new bone formation.

Moreover, the visualization and detection of new bone formation within the body (in vivo) become challenging, despite its potential clinical implications.

“Such subtle changes are challenging to visualize in vivo, in particular in the vicinity of a metallic implant causing artifacts on computed tomography images. However, through the new availability of an ultra-high-resolution CT scanner, we were encouraged to investigate this,” says study co-lead author Floris Heutink, MD, MSc, from the department of otorhinolaryngology at Radboud University Medical Center (Radboudumc) in Nijmegen, the Netherlands.

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Clinical Advancements

The study “Ultra-High-Resolution CT to Detect Intracochlear New Bone Formation after Cochlear Implantation” intended to detect the new bone formation in vivo by utilizing ultra-high spatial resolution CT (UHRCT) among 123 cochlear implant patients.

It was found that 83 (68%) patients (among the 123 patients) had new bone formation within 4 years of implantation, especially at the base of the cochlea. In addition, the new bone formation was also associated with long-term residual hearing loss in the group.

“As indicated by our study, there is a correlation between new bone formation and long-term residual hearing loss,”says study co-author Berit M. Verbist, MD, PhD, from the departments of radiology at Radboudumc and Leiden University Medical Center in Leiden, the Netherlands.

Negative Outcomes of New Bone Formation

There are several negative consequences to cochlear implant electrodes due to new bone formation:
  • Affects the spread of electrical current within the cochlea
  • This leads to complex device fitting and channel interaction
  • Overall poor hearing outcome
  • Complicates future gene therapies for cochlear function restoration

Need for Better Insights

As the study demonstrates several ill consequences of new bone formation, the evidence imparts an urgent need for diagnostic modalities to further improve the therapeutic consequences of cochlear implants.

“Last but not least, new bone formation may complicate reimplantation surgery. This technique will be a valuable tool to gain insight into occurrence, time course and the pathophysiology of this process and maybe used to evaluate still-to-be-developed treatments against new bone formation,” says Dr. Verbist.

Reference:
  1. Ultra-High-Resolution CT to Detect Intracochlear New Bone Formation after Cochlear Implantation - (https://pubs.rsna.org/doi/10.1148/radiol.211400)


Source-Medindia


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