Neurotrophins and cochlear implants: a solution to sensorineural deafness?
OBJECTIVE
To review current trends for treating sensorineural deafness by enhancing spiral ganglion neuron (SGN) survival using neurotrophins combined with cochlear implants and identify areas for future research and development.


METHODS
A literature search was undertaken on PubMed and Google scholar using terms: neurotrophins, cochlear implants (CIs), and sensorineural to identify the most recent and significant publications. The abstracts were read to identify relevant papers; these were accessed in full and analysed for this review.


RESULTS
Neurotrophins have a known role in cochlear development and the maintenance of SGNs. So far experiments using osmotic pumps to deliver neurotrophins have been successful for short-term enhanced survival of SGN's following aminoglycoside ototoxicity in animal models. They have demonstrated the re-sprouting of radial nerve fibres from SGN's towards the source of delivery. In addition electrical stimulation, gene and cell-based therapy have increased SGN survival to varying degrees.


CONCLUSIONS
Osmotic pumps carry a high risk of infection therefore CIs coated in a drug containing polymer or hydrogel are a realistic alternative for sustained delivery of neurotrophins. Increased SGN survival combined with neuronal re-growth raises the possibility for CIs to stimulate discrete SGN populations. Unfortunately, the duration of treatment needed for long-term survival still remains unclear and further work is needed. Nevertheless the combination of regenerative medicine to CI technology presents a novel approach to developing CI technology.
Ali
A
Sameer Mallick
Ali
A
Qureishi
Richard
R
Pearson
Gerrard
G
O'Donoghue
D000818:Animals; D002470:Cell Survival; D019929:Cochlear Implantation; D003054:Cochlear Implants; D003131:Combined Modality Therapy; D003638:Deafness / Q000188:drug therapy / Q000534:rehabilitation / Q000628:therapy*; D004558:Electric Stimulation; D006319:Hearing Loss, Sensorineural / Q000188:drug therapy / Q000534:rehabilitation / Q000628:therapy*; D006801:Humans; D009414:Nerve Growth Factors / Q000502:physiology / Q000627:therapeutic use*; D013136:Spiral Ganglion / Q000187:drug effects / Q000502:physiology
D009414:Nerve Growth Factors