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Inflammation at the tissue-electrode interface in a case of rapid deterioration in hearing performance leading to explant after cochlear implantation

Inflammation at the tissue-electrode interface in a case of rapid deterioration in hearing performance leading to explant after cochlear implantation
Inflammation at the tissue-electrode interface in a case of rapid deterioration in hearing performance leading to explant after cochlear implantation
Objective: The reasons for soft failure after cochlear implantation require investigation. This study proposes a method to study and characterize the tissue response to the array in a case of soft failure in a person undergoing reimplantation.

Case: The woman in her 50s, with an underlying autoimmune condition, received a cochlear implant using hearing preservation technique after developing profound hearing loss more than 2 kHz with a moderate loss of less than 500 Hz over a 10-year period. The case was identified as a soft failure due to deteriorating performance, discomfort, and migration over the 10 months after implantation. Impedance telemetry, speech perception measures, and audiometric thresholds are described. At explantation there was evidence of fibrosis.

Interventions: To use histology and immunohistochemistry to determine the cellular response of the tissue associated with the electrode array at time of explantation.

Main outcome measures: Identification of the cell types, regional variations, and inflammatory marker expression in the fibrotic tissue associated with the array.

Results: Neutrophils and eosinophils were identified, along with a variable pattern of collagen deposition. CD68 and CD163-positive macrophages and T cells were variably distributed through the tissue and interleukin-1 beta and vascular endothelial growth factor receptor-2 expression was identified.

Conclusions: The expression profile is evidence of active inflammation in the tissue despite the time since implantation. This study is the first to characterize the tissue response to the array in a person undergoing reimplantation, and who can be followed to determine the individual response to arrays. It establishes that the investigation of explanted devices after soft-failure is feasible.
1531-7129
e445-e450
Hough, Katie
81d8630c-6e02-4bea-858a-377717476f6e
Sanderson, Alan
ea92395a-998b-4bbb-ba91-24b2b1d4f6aa
Grasmeder, Mary
206e6b44-d1cd-43f5-99ac-588ab02d44ef
Mitchell, Tim
125f5e0f-500f-4ac2-8c54-9273c8f11cde
Verschuur, Carl
5e15ee1c-3a44-4dbe-ad43-ec3b50111e41
Newman, Tracey
322290cb-2e9c-445d-a047-00b1bea39a25
Hough, Katie
81d8630c-6e02-4bea-858a-377717476f6e
Sanderson, Alan
ea92395a-998b-4bbb-ba91-24b2b1d4f6aa
Grasmeder, Mary
206e6b44-d1cd-43f5-99ac-588ab02d44ef
Mitchell, Tim
125f5e0f-500f-4ac2-8c54-9273c8f11cde
Verschuur, Carl
5e15ee1c-3a44-4dbe-ad43-ec3b50111e41
Newman, Tracey
322290cb-2e9c-445d-a047-00b1bea39a25

Hough, Katie, Sanderson, Alan, Grasmeder, Mary, Mitchell, Tim, Verschuur, Carl and Newman, Tracey (2021) Inflammation at the tissue-electrode interface in a case of rapid deterioration in hearing performance leading to explant after cochlear implantation. Otology & Neurotology, 42 (4), e445-e450. (doi:10.1097/MAO.0000000000003014).

Record type: Article

Abstract

Objective: The reasons for soft failure after cochlear implantation require investigation. This study proposes a method to study and characterize the tissue response to the array in a case of soft failure in a person undergoing reimplantation.

Case: The woman in her 50s, with an underlying autoimmune condition, received a cochlear implant using hearing preservation technique after developing profound hearing loss more than 2 kHz with a moderate loss of less than 500 Hz over a 10-year period. The case was identified as a soft failure due to deteriorating performance, discomfort, and migration over the 10 months after implantation. Impedance telemetry, speech perception measures, and audiometric thresholds are described. At explantation there was evidence of fibrosis.

Interventions: To use histology and immunohistochemistry to determine the cellular response of the tissue associated with the electrode array at time of explantation.

Main outcome measures: Identification of the cell types, regional variations, and inflammatory marker expression in the fibrotic tissue associated with the array.

Results: Neutrophils and eosinophils were identified, along with a variable pattern of collagen deposition. CD68 and CD163-positive macrophages and T cells were variably distributed through the tissue and interleukin-1 beta and vascular endothelial growth factor receptor-2 expression was identified.

Conclusions: The expression profile is evidence of active inflammation in the tissue despite the time since implantation. This study is the first to characterize the tissue response to the array in a person undergoing reimplantation, and who can be followed to determine the individual response to arrays. It establishes that the investigation of explanted devices after soft-failure is feasible.

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Hough et al. ON-20-510 - Accepted Manuscript
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Accepted/In Press date: 29 September 2020
Published date: 1 April 2021

Identifiers

Local EPrints ID: 444528
URI: http://eprints.soton.ac.uk/id/eprint/444528
ISSN: 1531-7129
PURE UUID: aade252f-ec1f-48ef-aa73-198157d649fe
ORCID for Katie Hough: ORCID iD orcid.org/0000-0002-5160-2517
ORCID for Tracey Newman: ORCID iD orcid.org/0000-0002-3727-9258

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Date deposited: 22 Oct 2020 16:34
Last modified: 12 Jun 2024 04:06

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Contributors

Author: Katie Hough ORCID iD
Author: Alan Sanderson
Author: Mary Grasmeder
Author: Tim Mitchell
Author: Carl Verschuur
Author: Tracey Newman ORCID iD

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