Measurement of the Intracochlear Hypothermia Distribution Utilizing Tympanic Cavity Hypothermic Rinsing Technique in a Cochlea Hypothermia Model
Introduction: Cochlea implants can cause severe trauma leading to intracochlear apoptosis, fibrosis, and eventually to loss of residual hearing. Mild hypothermia has been shown to reduce toxic or mechanical noxious effects, which can result in inflammation and subsequent hearing loss. This paper eva...
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doaj-c5c89836638445f89897639f3d352df62021-01-11T05:26:35ZengFrontiers Media S.A.Frontiers in Neurology1664-22952021-01-011110.3389/fneur.2020.620691620691Measurement of the Intracochlear Hypothermia Distribution Utilizing Tympanic Cavity Hypothermic Rinsing Technique in a Cochlea Hypothermia ModelWerner Bader0Timo Gottfried1Gerald Degenhart2Lejo Johnson Chacko3Daniel Sieber4Herbert Riechelmann5Natalie Fischer6Romed Hoermann7Rudolf Glueckert8Anneliese Schrott-Fischer9Joachim Schmutzhard10Department of Otorhinolaryngology, Medical University Innsbruck, Innsbruck, AustriaDepartment of Otorhinolaryngology, Medical University Innsbruck, Innsbruck, AustriaDepartment of Radiology, University Clinics Innsbruck, Innsbruck, AustriaDepartment of Otorhinolaryngology, Medical University Innsbruck, Innsbruck, AustriaMED-EL Medical Electronics GesmbH, Research and Development, Innsbruck, AustriaDepartment of Otorhinolaryngology, Medical University Innsbruck, Innsbruck, AustriaDepartment of Otorhinolaryngology, Medical University Innsbruck, Innsbruck, AustriaDepartment of Anatomy, Histology, and Embryology, Medical University Innsbruck, Innsbruck, AustriaDepartment of Otorhinolaryngology, Medical University Innsbruck, Innsbruck, AustriaDepartment of Otorhinolaryngology, Medical University Innsbruck, Innsbruck, AustriaDepartment of Otorhinolaryngology, Medical University Innsbruck, Innsbruck, AustriaIntroduction: Cochlea implants can cause severe trauma leading to intracochlear apoptosis, fibrosis, and eventually to loss of residual hearing. Mild hypothermia has been shown to reduce toxic or mechanical noxious effects, which can result in inflammation and subsequent hearing loss. This paper evaluates the usability of standard surgical otologic rinsing as cooling medium during cochlea implantation as a potential hearing preservation technique.Material and Methods: Three human temporal bones were prepared following standard mastoidectomy and posterior tympanotomy. Applying a retrocochlear approach leaving the mastoidectomy side intact, temperature probes were placed into the basal turn (n = 4), the middle turn (n = 2), the helicotrema, and the modiolus. Temperature probe positions were visualized by microcomputed tomography (μCT) imaging and manually segmented using Amira® 7.6. Through the posterior tympanotomy, the tympanic cavity was rinsed at 37°C in the control group, at room temperature (in the range between 22 and 24°C), and at iced water conditions. Temperature changes were measured in the preheated temporal bone. In each temperature model, rinsing was done for 20 min at the pre-specified temperatures measured in 0.5-s intervals. At least five repetitions were performed. Data were statistically analyzed using pairwise t-tests with Bonferroni correction.Results: Steady-state conditions achieved in all three different temperature ranges were compared in periods between 150 and 300 s. Temperature in the inner ear started dropping within the initial 150 s. Temperature probes placed at basal turn, the helicotrema, and middle turn detected statistically significant fall in temperature levels following body temperature rinses. Irrigation at iced conditions lead to the most significant temperature drops. The curves during all measurements remained stable with 37°C rinses.Conclusion: Therapeutic hypothermia is achieved with standard surgical irrigation fluid, and temperature gradients are seen along the cochlea. Rinsing of 120 s duration results in a therapeutic local hypothermia throughout the cochlea. This otoprotective procedure can be easily realized in clinical practice.https://www.frontiersin.org/articles/10.3389/fneur.2020.620691/fulllocal hypothermiacochleacochlea temperature modelsurgical irrigationtemporal bone study |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Werner Bader Timo Gottfried Gerald Degenhart Lejo Johnson Chacko Daniel Sieber Herbert Riechelmann Natalie Fischer Romed Hoermann Rudolf Glueckert Anneliese Schrott-Fischer Joachim Schmutzhard |
spellingShingle |
Werner Bader Timo Gottfried Gerald Degenhart Lejo Johnson Chacko Daniel Sieber Herbert Riechelmann Natalie Fischer Romed Hoermann Rudolf Glueckert Anneliese Schrott-Fischer Joachim Schmutzhard Measurement of the Intracochlear Hypothermia Distribution Utilizing Tympanic Cavity Hypothermic Rinsing Technique in a Cochlea Hypothermia Model Frontiers in Neurology local hypothermia cochlea cochlea temperature model surgical irrigation temporal bone study |
author_facet |
Werner Bader Timo Gottfried Gerald Degenhart Lejo Johnson Chacko Daniel Sieber Herbert Riechelmann Natalie Fischer Romed Hoermann Rudolf Glueckert Anneliese Schrott-Fischer Joachim Schmutzhard |
author_sort |
Werner Bader |
title |
Measurement of the Intracochlear Hypothermia Distribution Utilizing Tympanic Cavity Hypothermic Rinsing Technique in a Cochlea Hypothermia Model |
title_short |
Measurement of the Intracochlear Hypothermia Distribution Utilizing Tympanic Cavity Hypothermic Rinsing Technique in a Cochlea Hypothermia Model |
title_full |
Measurement of the Intracochlear Hypothermia Distribution Utilizing Tympanic Cavity Hypothermic Rinsing Technique in a Cochlea Hypothermia Model |
title_fullStr |
Measurement of the Intracochlear Hypothermia Distribution Utilizing Tympanic Cavity Hypothermic Rinsing Technique in a Cochlea Hypothermia Model |
title_full_unstemmed |
Measurement of the Intracochlear Hypothermia Distribution Utilizing Tympanic Cavity Hypothermic Rinsing Technique in a Cochlea Hypothermia Model |
title_sort |
measurement of the intracochlear hypothermia distribution utilizing tympanic cavity hypothermic rinsing technique in a cochlea hypothermia model |
publisher |
Frontiers Media S.A. |
series |
Frontiers in Neurology |
issn |
1664-2295 |
publishDate |
2021-01-01 |
description |
Introduction: Cochlea implants can cause severe trauma leading to intracochlear apoptosis, fibrosis, and eventually to loss of residual hearing. Mild hypothermia has been shown to reduce toxic or mechanical noxious effects, which can result in inflammation and subsequent hearing loss. This paper evaluates the usability of standard surgical otologic rinsing as cooling medium during cochlea implantation as a potential hearing preservation technique.Material and Methods: Three human temporal bones were prepared following standard mastoidectomy and posterior tympanotomy. Applying a retrocochlear approach leaving the mastoidectomy side intact, temperature probes were placed into the basal turn (n = 4), the middle turn (n = 2), the helicotrema, and the modiolus. Temperature probe positions were visualized by microcomputed tomography (μCT) imaging and manually segmented using Amira® 7.6. Through the posterior tympanotomy, the tympanic cavity was rinsed at 37°C in the control group, at room temperature (in the range between 22 and 24°C), and at iced water conditions. Temperature changes were measured in the preheated temporal bone. In each temperature model, rinsing was done for 20 min at the pre-specified temperatures measured in 0.5-s intervals. At least five repetitions were performed. Data were statistically analyzed using pairwise t-tests with Bonferroni correction.Results: Steady-state conditions achieved in all three different temperature ranges were compared in periods between 150 and 300 s. Temperature in the inner ear started dropping within the initial 150 s. Temperature probes placed at basal turn, the helicotrema, and middle turn detected statistically significant fall in temperature levels following body temperature rinses. Irrigation at iced conditions lead to the most significant temperature drops. The curves during all measurements remained stable with 37°C rinses.Conclusion: Therapeutic hypothermia is achieved with standard surgical irrigation fluid, and temperature gradients are seen along the cochlea. Rinsing of 120 s duration results in a therapeutic local hypothermia throughout the cochlea. This otoprotective procedure can be easily realized in clinical practice. |
topic |
local hypothermia cochlea cochlea temperature model surgical irrigation temporal bone study |
url |
https://www.frontiersin.org/articles/10.3389/fneur.2020.620691/full |
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