Evaluating the efficacy of L-N-acetylcysteine and dexamethasone in combination to provide otoprotection for electrode insertion trauma

Eshraghi A. A., Shahal D., Davies C., Mittal J., Shah V., BULUT E., ...More

Journal of Clinical Medicine, vol.9, no.3, 2020 (SCI-Expanded, Scopus)

  • Publication Type: Article / Article
  • Volume: 9 Issue: 3
  • Publication Date: 2020
  • Doi Number: 10.3390/jcm9030716
  • Journal Name: Journal of Clinical Medicine
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, EMBASE, Directory of Open Access Journals
  • Keywords: Dexamethasone, Electrode insertion trauma, L-N-acetylcysteine, Nitric oxide, Organ of Corti, Oxidative stress, Proinflammatory cytokines, Residual hearing
  • Trakya University Affiliated: Yes

Abstract

Background: Electrode insertion trauma (EIT) during cochlear implantation (CI) can cause loss of residual hearing. L-N-acetylcysteine (L-NAC) and dexamethasone (Dex) have been individually shown to provide otoprotection albeit at higher concentrations that may be associated with adverse effects. Objective/Aims: The aim of this study is to determine whether L-NAC and Dex could be combined to decrease their effective dosage. Materials and Methods: The organ of Corti (OC) explants were divided into various groups: 1) control; 2) EIT; 3) EIT treated with different concentrations of Dex; 4) EIT treated with different concentrations of L-NAC; 5) EIT treated with L-NAC and Dex in combination. Hair cell (HC) density, levels of oxidative stress, proinflammatory cytokines and nitric oxide (NO) was determined. Results: There was a significant loss of HCs in explants subjected to EIT compared to the control group. L-NAC and Dex in combination was able to provide significant otoprotection at lower concentrations compared to individual drugs. Conclusions and Significance: A combination containing L-NAC and Dex is effective in protecting sensory cells at lower protective doses than each compound separately. These compounds can be combined allowing a decrease of potential side effects of each compound and providing significant otoprotection for EIT.