Is there an inflammatory signature of the middle ear that identifies children at risk of poor hearing with a cochlear implant?

Hough, Kate, Reddin, Ian, Nichani, Jaya, Findlay, Callum Andrew, Bruce, Iain A. and Newman, Tracey (2025) Is there an inflammatory signature of the middle ear that identifies children at risk of poor hearing with a cochlear implant? Faculty of Medicine Research Conference, , Southampton, United Kingdom. 26 Jun 2025.

Abstract

Background: middle ear infection/inflammation (otitis media) is a leading cause of hearing loss worldwide. Otitis media in childhood increases the risk of hearing loss in adulthood and can affect outcomes following cochlear implantation.

Cochlear implants can be life-changing for deaf children. Unfortunately, some children don’t achieve the expected hearing with their implant. Poorer hearing can be caused by aberrant tissue growth, or fibrosis, around the implant. The mechanism is poorly understood.

Preclinical and temporal bone studies have shown that otitis media causes macrophage-associated inflammation and damage within the cochlea. There is little understanding of how inflammatory signalling from the middle ear activates cochlear macrophages and how this could affect hearing with a cochlear implant.

Aim: to determine whether the inflammatory state of the middle ear, at implantation, is a biological factor contributing to poor performance in children with implants.

Methods: CHIEF (cochlear implants and inner ear inflammation) is a cross-sectional study of children undergoing cochlear implantation. Samples of the middle ear mucosa and cochlear fluid have been collected during surgery. A study database of clinical and hearing data spanning five years post-implantation is being built.

Results: working with BioR, we carried out secondary analysis of single-cell RNA-sequencing data from a preclinical otitis media model. We identified strong interactions between pro-inflammatory macrophages and fibroblasts in rodent middle ear mucosa. The single-cell transcriptome of the human inflamed middle ear remains largely unexplored.

Using spatial transcriptomics (CosMx), we aim to characterise the spatial gene profile and intercellular interactions of macrophages and fibroblasts in the middle ear mucosa collected through CHIEF.

Conclusion: the relationship between the biological and clinical data will be analysed to interrogate how the inflammatory signature of the ear is associated with long-term hearing outcomes. If a predictable relationship is determined, anti-inflammatories could be used to modulate inflammation and improve hearing following implantation.

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Contributors

Author: Kate Hough

Author: Ian Reddin

Author: Callum Andrew Findlay

Author: Tracey Newman

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