Drug delivery devices

As an alternative to systemic administration, several local delivery approaches to restore hearing are gaining more and more interest in the field. Reaching the cochlea remains the biggest challenge faced by clinicians treating inner ear diseases: this tiny organ is particularly difficult to access, encased in a dense layer of bone and protected by the blood-cochlear barrier.

Intracochlear drug delivery systems:
a promising approach to treat hearing loss

While a transtympanic injection is the most frequently used local delivery method, it can provide variable levels of drug exposure for a limited time in the cochlea.

Therefore, many drug delivery devices are under development to deliver therapeutics directly into the inner ear and offer the benefit of dosing drugs precisely for extended periods: infusion pumps, cochlear implants, microneedle-based penetration of the RWM, magnetic nanoparticles, etc.

Schematic of the delivery chip component of an intracochlear drug delivery (ICDD) device comprising microfluidic drug storage and flow control. The ICDD device is connected, via a small tube inserted into the scala tympani, to the basal turn of the human cochlea to show potential clinical implementation. Peppi et al, 2018.

Cochlear implants

Cochlear implants offer significant benefits for children and adults with severe to profound hearing loss. Remarkable developments of these devices have been made possible as a result of a close collaboration of audiologists, engineers, and ENT surgeons, who never stop innovating:  individualization, miniaturization of electronic components, use of mobile application; these are all on their way to becoming the standard of care for tomorrow.

The greatest challenge of cochlear implants is in preserving cochlear structure and residual neurosensorial cells to meet the following objectives:

  • Improving the duration and performance of the device (impedance monitoring)
  • Assessing combinations with therapeutics of interest for cochlear protection
  • Ensuring safety with the prevention of fibrous tissue & new bone formation around the electrode array

CILcare offers robust in vivo models to assess the efficacy & safety of cochlear implants:

Surgical approaches

Main read-outs

  • Measurement of ABR to assess the impact of the implant on the overall cochlear function and on the related surgery with no implant
  • Measurement of impedance to assess the proper functioning of the electrode array
  • Cochlear implant programming using Auto-NRT* thresholds
  • Histology: cochleogram, distribution of the fibrotic tissue with trichrome staining

*Neural Response Telemetry

″Researchers & developers need to be guided by experts in molecular biology and pharmacology of the auditory system, highly experienced in local drug delivery to reach the inner ear, and perfectly trained in otic surgical processes. This is what CILcare does.″