Therapeutic hypothermia to preserve residual hearing in veterans receiving cochlear implantation

低温治疗可保护接受人工耳蜗植入的退伍军人的残余听力

• 批准号: 10314602
• 负责人: Suhrud M. Rajguru
• 金额: --
• 依托单位: MIAMI VA HEALTH CARE SYSTEM
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-03-01 至 2026-02-28
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10314602
• 关键词: Acoustic Stimulation; Acoustics; Acute; Anatomy; Auditory; Auditory Threshold; Blood Vessels; Chronic; Clinical; Cochlea; Cochlear Implants; Cochlear implant procedure; Custom; Data; Deterioration; Development; Devices; Electric Stimulation; Environment; Experimental Models; Exposure to; Frequencies; Functional disorder; Goals; Hair Cells; Hearing; Hearing problem; Histologic; Hour; Implant; Inflammation; Injury; Intervention; Knowledge; Labyrinth; Link; Maintenance; Measurement; Mechanics; Modeling; Neurons; Noise; Noise-Induced Hearing Loss; Operative Surgical Procedures; Organ of Corti; Otologic Surgical Procedures; Outcome; Outer Hair Cells; Oxidative Stress; Pathology; Patients; Phenotype; Physiological; Pre-Clinical Model; Protocols documentation; Publishing; Rattus; Rehabilitation therapy; Reporting; Research; Residual state; Rewarming; Risk; Rodent Model; Safety; Sensorineural Hearing Loss; Sensory; Sensory Hair; Services; Speech; Speech Perception; Structure; Surgical Injuries; Synapses; Temperature; Temporary Threshold Shift; Testing; Therapeutic; Therapeutic Intervention; Time; Translations; Trauma; Treatment Protocols; Tube; Vesicle; Veterans; Work; auditory threshold shift; blast exposure; clinical translation; cost; design; disability; efficacy testing; ganglion cell; hearing impairment; hearing preservation; histological studies; implantable device; implantation; improved; middle ear; military service; natural hypothermia; neuroprosthesis; noise exposure; normal hearing; novel; post-trauma; pre-clinical; preservation; presynaptic; prevent; relating to nervous system; ribbon synapse; service member; speech recognition; spiral ganglion; surgical risk; therapy duration; treatment optimization

The primary goal of this proposal is to test and develop a novel application of therapeutic hypothermia for veterans receiving cochlear implantation (CI) with an aim to preserve residual hearing and sensitive neural structures against surgical trauma and improve hearing outcomes post-implantation. Increasing residual hearing in veterans post-CI will likely improve their speech recognition outcomes, improve speech perception in quiet, and overall, patient benefit and usage of these devices. An increasing number of patients, that include our veterans, have some level of residual hearing at the time of implantation and can benefit from bimodal electro- acoustic devices. Surviving hair cell activity and as a result a functioning organ of Corti and neural substrate has recently been linked to speech perception outcomes. However, trauma during implantation leads to inflammation and oxidative stress that can exacerbate residual hearing loss. Successful translation of therapeutic interventions to limit pathophysiology of the injury have yet to be achieved. The present work aims to develop application(s) of localized, therapeutic hypothermia for protection of hair cells and neural substrate following CI in compromised cochleae as a result of noise and blast exposures in veterans. The specific aims are motivated by a gap in knowledge currently of the pathophysiology of CI in compromised cochleae, its relation to poor outcomes in veterans, and our preliminary data showing that localized, mild hypothermia delivered to the cochlea is effective and safe therapeutic intervention for preserving residual hearing after implantation. The results from this project can be further extended to other inner and middle ear surgeries in veterans, surgeries that also carry a risk of residual hearing loss.

该提案的主要目标是测试和开发一种低温治疗的新应用 接受人工耳蜗植入 (CI) 的退伍军人，旨在保留残余听力和敏感神经 抗手术创伤的结构并改善植入后的听力结果。增加残余听力 在退伍军人中，CI 后可能会改善他们的语音识别结果，改善安静时的语音感知， 总体而言，患者的利益和这些设备的使用。越来越多的患者，其中包括我们 退伍军人在植入时具有一定程度的残余听力，可以受益于双模电 声学设备。幸存的毛细胞活性以及由此产生的柯蒂功能器官和神经基质 最近与言语感知结果相关。然而，植入过程中的创伤会导致炎症 氧化应激会加剧残余听力损失。治疗干预措施的成功转化 限制损伤的病理生理学尚未实现。目前的工作旨在开发应用程序 局部治疗性低温保护受损患者 CI 后的毛细胞和神经基质 退伍军人因噪音和爆炸暴露而导致耳蜗损伤。具体目标是由差距推动的 目前对受损耳蜗 CI 病理生理学的了解及其与不良预后的关系 退伍军人，我们的初步数据表明，传递到耳蜗的局部轻度低温是有效的 以及用于保留植入后残余听力的安全治疗干预。该项目的结果 可以进一步扩展到退伍军人的其他内耳和中耳手术，这些手术也存在风险 残余听力损失。