PMID- 29240567
OWN - NLM
STAT- MEDLINE
DCOM- 20190314
LR  - 20190329
IS  - 1538-4667 (Electronic)
IS  - 0196-0202 (Linking)
VI  - 39
IP  - 4
DP  - 2018 Jul/Aug
TI  - Theoretical Evaluation and Experimental Validation of Localized Therapeutic
      Hypothermia Application to Preserve Residual Hearing After Cochlear Implantation.
PG  - 712-719
LID - 10.1097/AUD.0000000000000529 [doi]
AB  - OBJECTIVES: Cochlear implantation surgery has been shown to result in trauma to
      inner ear sensory structures, resulting in loss of residual hearing. Localized
      therapeutic hypothermia has been shown in clinical care to be a neuroprotective
      intervention. Previously, we have shown in an experimental model that localized
      hypothermia protects cochlear hair cells and residual hearing function against
      surgical and cochlear implantation trauma. Using experimental temperature
      measurements carried out in human cadaver temporal bones and a finite element
      model of the inner ear, the present study examined the temperature distribution
      of a custom-designed hypothermia delivery system in the human inner ear organs.
      DESIGN: The efficacy of the hypothermia probe and resulting heat distribution
      across human cochlea and surrounding tissues were modeled in three-dimensional in
      COMSOL. The geometry and dimensions of inner ear and temporal bones were derived 
      from computed tomographic and magnetic resonance imaging images. Model
      predictions were compared with experimental observations from five human temporal
      bones. RESULTS: In both the modeling and experimental studies, the cochlear
      temperature was lowered by 4 to 6 degrees C on the round window from a baseline
      of 37 degrees C within 16 to 18 minutes. The model simulations showed uniformly
      distributed cooling across the cochlea. This study provides insight for design,
      operation, and protocols for efficacious delivery of mild therapeutic hypothermia
      to the human cochlea that may significantly benefit patients undergoing surgical 
      cochlear implantation by preserving residual hearing. CONCLUSION: There was a
      close correlation between the results of the numerical simulations and
      experimental observations in this study. Our custom-designed system is capable of
      effectively providing mild therapeutic hypothermia locally to the human cochlea. 
      When combined with results from in vivo animal experiments, the present study
      suggests that the application of localized therapeutic hypothermia may hold
      potential for patients with an aim to preserve residual hearing after cochlear
      implantation.
FAU - Tamames, Ilmar
AU  - Tamames I
AD  - Department of Biomedical Engineering, University of Miami, Miami, Florida, USA.
FAU - King, Curtis
AU  - King C
AD  - Lucent Medical Systems, Seattle, Washington, USA.
FAU - Huang, Chin-Yuh
AU  - Huang CY
AD  - Department of Biomedical Engineering, University of Miami, Miami, Florida, USA.
FAU - Telischi, Fred F
AU  - Telischi FF
AD  - Department of Otolaryngology, University of Miami, Miami, Florida, USA.
FAU - Hoffer, Michael E
AU  - Hoffer ME
AD  - Department of Otolaryngology, University of Miami, Miami, Florida, USA.
FAU - Rajguru, Suhrud M
AU  - Rajguru SM
AD  - Department of Biomedical Engineering, University of Miami, Miami, Florida, USA.
AD  - Department of Otolaryngology, University of Miami, Miami, Florida, USA.
LA  - eng
GR  - R01 DC013798/DC/NIDCD NIH HHS/United States
GR  - R21 DC014324/DC/NIDCD NIH HHS/United States
GR  - UL1 TR000460/TR/NCATS NIH HHS/United States
GR  - UL1 TR002736/TR/NCATS NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
PT  - Validation Studies
PL  - United States
TA  - Ear Hear
JT  - Ear and hearing
JID - 8005585
SB  - IM
MH  - Cadaver
MH  - *Cochlea
MH  - *Cochlear Implantation
MH  - Ear, Inner
MH  - Finite Element Analysis
MH  - *Hearing
MH  - Humans
MH  - Hypothermia, Induced/*methods
MH  - Imaging, Three-Dimensional
MH  - Models, Theoretical
MH  - Postoperative Care/*methods
MH  - *Temperature
PMC - PMC5999525
MID - NIHMS915965
EDAT- 2017/12/15 06:00
MHDA- 2019/03/15 06:00
CRDT- 2017/12/15 06:00
PMCR- 2019/07/01 00:00
PHST- 2019/07/01 00:00 [pmc-release]
PHST- 2017/12/15 06:00 [pubmed]
PHST- 2019/03/15 06:00 [medline]
PHST- 2017/12/15 06:00 [entrez]
AID - 10.1097/AUD.0000000000000529 [doi]
PST - ppublish
SO  - Ear Hear. 2018 Jul/Aug;39(4):712-719. doi: 10.1097/AUD.0000000000000529.