Evaluating calcium channel blockers and bisphosphonates as otoprotective agents in cochlear implantation hearing preservation candidates

Abstract

Objectives:

Evaluate potential effects of calcium channel blockers (CCB) and bisphosphonates (BP) on residual hearing following cochlear implantation.

Methods:

Medications of 303 adult hearing preservation (HP) candidates (low frequency pure tone average [LFPTA] of 125, 250, and 500 Hz ≤80 dB HL) were reviewed. Postimplantation LFPTA of patients taking CCBs and BPs were compared to controls matched by age and preimplantation LFPTA.

Results:

Twenty-six HP candidates were taking a CCB (N = 14) or bisphosphonate (N = 12) at implantation. Median follow-up was 1.37 years (range 0.22–4.64y). Among subjects with initial HP, 29% (N = 2 of 7) CCB users compared to 50% (N = 2 of 4) controls subsequently lost residual hearing 3–6 months later (OR = 0.40, 95% CI = 0.04–4.32, p = 0.58). None of the four BP patients with initial HP experienced delayed loss compared to 50% (N = 2 of 4) controls with initial HP (OR = 0.00, 95% CI = 0.00–1.95, P = 0.43). Two CCB and one BP patients improved to a LFPTA <80 dB HL following initial unaided thresholds that suggested loss of residual hearing.

Discussion:

There were no significant differences in the odds of delayed loss of residual hearing with CCBs or BPs.

Conclusion:

Further investigation into potential otoprotective adjuvants for maintaining residual hearing following initial successful hearing preservation is warranted, with larger cohorts and additional CCB/BP agents.

Keywords:

• Cochlear implantation
• Hearing preservation
• Calcium channel blockers
• Bisphosphonates
• Aural rehabilitation

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.

Notes on contributors

Kristen L. Yancey

Kristen L. Yancey is an assistant professor of neurotology at Weill Cornell Medical Center. Her research interests include cochlear implant outcomes, modifiable hearing loss risk factors, and lateral skull base pathology.

Ankita Patro

Ankita Patro, MD is completing her fellowship in Neurotology at Vanderbilt Medical Center.

Miriam Smetak

Miriam Smetak, MD is completing her fellowship in Neurotology at Washington University in St. Louis, MO.

Elizabeth L. Perkins

Elizabeth L. Perkins, MD - Assistant Professor of Neurotology within the Department of Otolaryngology-Head and Neck Surgery Department at Vanderbilt Medical Center. She has a robust clinical practice and her research focuses on cochlear implantation outcomes, same-day CI surgery, and hearing preservation.

Brandon Isaacson

Brandon Isaacson, MD - Professor of Neurotology within the Department of Otolaryngology-Head and Neck Surgery Department at UTSW. His clinical research focus includes cochlear implant outcomes, endoscopic ear surgery and paragangliomas. He is heavily involved in mentorship and surgical training of both residents and Neurotology fellows, and he chairs the Otolaryngology Resident Selection Committee.

Marc L. Bennett

Marc L. Bennett, MD, MMHC is a professor of Neurotology at the Otology Group at Vanderbilt performing research on cochlear implants, hearing outcomes, and skull base tumors.

Matthew O'Malley

Matthew O'Malley, MD - Assistant Professor of Neurotology within the Department of Otolaryngology-Head and Neck Surgery Department at Vanderbilt Medical Center. His clinical practice focuses on both lateral skull base pathology, otology and hearing restoration through cochlear implantation. He is actively engaged in clinical research as well as resident and fellow education.

David S. Haynes

David S. Haynes, MD, MMHC - Professor of Neurotology within the Department of Otolaryngology-Head and Neck Surgery Department at Vanderbilt Medical Center. He also serves as the Chief of the Neurotology Division and Neurotology Fellowship Program Director. His prolific research spans the breadth of Neurotology including cochlear implant outcomes, skull base pathology and chronic ear disease.

Jacob B. Hunter

Jacob Hunter, MD - Professor of Neurotology within the Department of Otolaryngology-Head and Neck Surgery Department at Thomas Jefferson University Hospital, where he leads the otology and lateral skull base division and is the director of the Cochlear Implant program.