Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P243

Poster Presentations

Preoperative N-Acetylcysteine and Steroids
for Hearing Preservation in Cochlear
Implant Surgery
Clifford S. Brown, MD (Presenter); Meredith A. Holcomb, AuD;
Chrisanda Sanchez, AuD; Simon I. Angeli, MD
Objectives: Hearing preservation with cochlear implant (CI)
improves listening in noise with electroacoustic stimulation. We
sought to determine the effects of perioperative N-acetylcysteine
(NAC) and dexamethasone on hearing preservation outcomes.
Methods: Retrospective comparison of pre- and postoperative audiometric data of CI patients at a tertiary referral center
from January 2015 to December 2019. Aidable hearing was
defined as thresholds <70 dB at 125, 250, and 500 Hz. Patients
received systemic NAC and prednisone starting 2 days prior
to surgery, extending 3 days postoperatively.
Results: Of 29 patients, 25 received steroid and NAC,
whereas 4 received steroids only. Mean age was 43 years
(range, 4-83 years) and 16 (55%) were women. Full insertion
of the 9 various electrodes occurred in 93% of patients (n =
27). Insertion via round window was performed in 25 cases
(86%). Average time for postoperative audiogram was 8.3
months (σ = 9). Aidable hearing was present in 16 patients
(55%) preimplantation and was preserved in 15 of these
patients (94%). The mean preoperative thresholds for 125,
250, and 500 Hz were 44.5 dB (σ = 19.4), 53.6 dB (σ = 21.1),
64.7 dB (σ = 20), with a 3-tone pure tone average (PTA) of
54.6 dB (σ = 19). The median threshold change at 125 Hz was
5 dB and was 10 dB at frequencies of 250 to 1000 Hz. The
average change in 3-tone PσTA was 10.1 dB (σ = 8.9). In
those receiving NAC in addition to steroids, the mean change
was 8.8 dB less than those receiving steroids alone (17.7 +
17.7 vs 8.9 + 6.6).
Conclusions: NAC and glucocorticoids may be safely implemented perioperatively in patients undergoing hearing preservation
CI. This cocktail, in addition to soft surgical techniques, may
preserve aidable hearing thresholds, permitting electroacoustic stimulation.
Prevalence of Hearing Loss in Patients With
Dementia
Brianda Cecilia Rosas-Razo, MD (Presenter);
Cynthia Cárdebasl; José Luis Ruiz; Andrea Mendl;
Hector Macias-Reyes, MD; Elia Anet Luna
Objectives: Hearing loss is a risk factor or associated condition for the eventual development of dementia and for its progression. There is evidence of a prevalence of hearing loss of
up to 60% in patients with dementia in first world countries.

The objective of this study is to know the prevalence of hearing loss in patients with dementia in our environment.
Methods: A cross-sectional and descriptive design study
considered patients with dementia of any type and severity
referred from the neurology services. The auditory evaluation
was carried out in the Audiology and Otolaryngology Service
by means of audiometry test and auditory steady-state evoked
potential. A total of 50 patients were evaluated in a period
between January 2019 and April 2019 with diagnosis of any
type of dementia.
Results: Presbyacusis is the main cause of hearing loss in
patients with dementia. The prevalence of hearing loss in
patients with dementia is high.
Conclusions: It is very important to assess the hearing status
of patients with dementia or at risk of suffering from it to limit
damage.
Prevention of Ischemia-Induced Hearing
Loss by Intravenous Administration of
Hydrogen-Rich Saline in Gerbils
Hideo Ogawa (Presenter); Masahiro Okada, MD;
Naohito Hato, MD
Objectives: Hydrogen-rich water, which is a potent antioxidant agent, was investigated for its protective effects against
ischemic damage of the cochlea in gerbils.
Methods: The animals were subjected to transient cochlear
ischemia by occluding the bilateral vertebral arteries for
l5 minutes. Five milliliters of hydrogen-rich saline was then
intravenously administered immediately after the insult.
Saline without hydrogen was used as a control. Effects of
hydrogen were evaluated using the auditory brainstem
response (ABR) and histological studies of the inner ear. We
performed this study from April 2015 to August 2016.
Results: In controls, transient cochlear ischemia caused a
24.2 ± 3.8 dB increase in the ABR threshold at 8 kHz and a
decrease of 14.1% ± 1.8% in the number of inner hair cells
(IHCs) at the basal turn on day 7. Ischemic damage was more
severe at 16 and 32 kHz. When the animals were treated with
hydrogen-rich saline, cochlear damage was significantly
reduced: the increase in ABR threshold was 11.7 ± 2.6 dB at 8
kHz, and the IHC loss was 7.5% ± 2.1% at the basal turn on day
7. The effects of hydrogen-rich saline were more prominent at
higher frequencies. The data are presented as means ± SD.
Statistical significance was assessed using the Mann-Whitney
U test. P values <.05 were considered statistically significant.
Conclusions: Intravenous administration of hydrogen-rich
saline was effective in preventing acute hearing loss due to
transient cochlear ischemia.
Prospective Validation of the COACH Score:
A Novel Chronic Ear Grading System
Ryan D. Tabtabai, MD (Presenter); Sandra Ho, MD;
Matthew B. Hanson, MD; Daniel P. Ballard, MD
Objectives: The COACH score is a novel chronic ear grading
system that attempts to provide otolaryngologists with a

Otology/Neurotology

Conclusions: This is the first histopathological study to
examine the CAP in individuals with CTE. Neuropathological
changes in the CAP were found in patients with CTE. Further
studies are warranted with a larger number of specimens to
more precisely characterize changes at each stage. Given the
tauopathy of the CAP, audiometric tests may potentially aid in
premortem diagnosis.

P243

Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts

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