TY - JOUR
T1 - Acquired sensorineural hearing loss in children: current research and therapeutic perspectives.
AU - Ralli, Massimo
AU - Rolesi, Rolando
AU - Anzivino, Roberta
AU - Turchetta, R.
AU - Fetoni, Anna Rita
PY - 2017
Y1 - 2017
N2 - The knowledge of mechanisms responsible for acquired sensorineural hearing loss in children, such as viral and bacterial infections, noise exposure, aminoglycoside and cisplatin ototoxicity, is increasing and progressively changing the clinical management of affected patients. Viral infections are by far the most relevant cause of acquired hearing loss, followed by aminoglycoside and platinum derivative ototoxicity; moreover, cochlear damage induced by noise overexposure, mainly in adolescents, is an emerging topic. Pharmacological approaches are still challenging to develop a truly effective cochlear protection; however, the use of steroids, antioxidants, antiviral drugs and other small molecules is encouraging for clinical practice. Most of evidence on the effectiveness of antioxidants is still limited to experimental models, while the use of corticosteroids and antiviral drugs has a wide correspondence in literature but with controversial safety. Future therapeutic perspectives include innovative strategies to transport drugs into the cochlea, such as molecules incorporated in nanoparticles that can be delivered to a specific target. Innovative approaches also include the gene therapy designed to compensate for abnormal genes or to make proteins by introducing genetic material into cells; finally, regenerative medicine (including stem cell approaches) may play a central role in the upcoming years in hearing preservation and restoration even if its role in the inner ear is still debated.
AB - The knowledge of mechanisms responsible for acquired sensorineural hearing loss in children, such as viral and bacterial infections, noise exposure, aminoglycoside and cisplatin ototoxicity, is increasing and progressively changing the clinical management of affected patients. Viral infections are by far the most relevant cause of acquired hearing loss, followed by aminoglycoside and platinum derivative ototoxicity; moreover, cochlear damage induced by noise overexposure, mainly in adolescents, is an emerging topic. Pharmacological approaches are still challenging to develop a truly effective cochlear protection; however, the use of steroids, antioxidants, antiviral drugs and other small molecules is encouraging for clinical practice. Most of evidence on the effectiveness of antioxidants is still limited to experimental models, while the use of corticosteroids and antiviral drugs has a wide correspondence in literature but with controversial safety. Future therapeutic perspectives include innovative strategies to transport drugs into the cochlea, such as molecules incorporated in nanoparticles that can be delivered to a specific target. Innovative approaches also include the gene therapy designed to compensate for abnormal genes or to make proteins by introducing genetic material into cells; finally, regenerative medicine (including stem cell approaches) may play a central role in the upcoming years in hearing preservation and restoration even if its role in the inner ear is still debated.
KW - Acquired hearing loss
KW - Cochlear implant
KW - Genetic diagnosis
KW - Otorhinolaryngology2734 Pathology and Forensic Medicine
KW - Pediatric otolaryngology
KW - Acquired hearing loss
KW - Cochlear implant
KW - Genetic diagnosis
KW - Otorhinolaryngology2734 Pathology and Forensic Medicine
KW - Pediatric otolaryngology
UR - http://hdl.handle.net/10807/112162
UR - http://www.actaitalica.it/issues/2017/6-2017/09_ralli.pdf
U2 - 10.14639/0392-100X-1574
DO - 10.14639/0392-100X-1574
M3 - Article
SN - 0392-100X
VL - 37
SP - 500
EP - 508
JO - Acta Otorhinolaryngologica Italica
JF - Acta Otorhinolaryngologica Italica
ER -