There has been an increase in hearing preservation cochlear implant (HPCI) surgery over the last decade. Both steroid and L-N-acetylcysteine (NAC) were used and investigated respectively in the past in HPCI surgery. Authors investigated the role of perioperative NAC and steroid use in HPCI surgery. In adults, the regime consisted of oral prednisone 50mg in the morning starting two days before surgery and continuing for three days after surgery, plus NAC 1200mg orally twice daily starting two days before surgery and continuing for a total of two weeks. Sixty-one patients were included; 41 of them received NAC and steroids perioperative regime and 20 did not. Functional aidable hearing was preserved in 85.4% of the intervention group and in 60% of the non-intervention group at one-year post-op. A deterioration of 8 dB in the intervention group versus 18 dB in the observation group at one year was also noted. One patient from each group lost their functional hearing at one year. Authors reported a limitation of non-randomisation and concluded that perioperative STE + NAC was safe and effective in functional hearing preservation one year after cochlear implantation. HPCI is increasing in popularity. Perioperative measures that prove effective and safe clinically are worth a thought while a higher quality research is awaited.
Hearing preservation in cochlear implantation – an American cocktail
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