A novel therapeutic pathway to the human cochlear nerve
Traditional approaches to the human cochlear nerve have been impeded by its bony encasement deep inside the skull base. We present an innovative, minimally invasive, therapeutic pathway for direct access to the nerve to deliver novel regenerative therapies. Neuroanatomical studies on 10 cadaveric human temporal bones were undertaken to identify a potentially safe therapeutic pathway to the cochlear nerve. Simulations based on three-dimensional delineation of anatomical structures obtained from synchrotron phase-contrast imaging were analyzed. This enabled the identification of an approach to the nerve in the fundus of the internal auditory meatus by trephining the medial modiolar wall of the cochlea via the round window for a median depth of 1.48 mm (range 1.21-1.91 mm). The anatomical access was validated on 9 additional human temporal bones using radio-opaque markers and contrast injection with micro-computed tomography surveillance. We thus created an effective conduit for the delivery of therapeutic agents to the cochlear nerve.
Authors
- Ning Zhu (ORCID: https://orcid.org/0000-0002-2633-9956)
- Daniela I. Cacciabue
- Sumit Agrawal (ORCID: https://orcid.org/0000-0002-1309-3838)
- Hanif M. Ladak (ORCID: https://orcid.org/0000-0003-4911-3340)
- Marcelo N. Rivolta (ORCID: https://orcid.org/0000-0003-4178-8570)
- Douglas E. H. Hartley (ORCID: https://orcid.org/0000-0001-9803-4169)
- Dan Jiang (ORCID: https://orcid.org/0000-0003-1490-6658)
- Helge Rask‐Andersen (ORCID: https://orcid.org/0009-0006-5736-0981)
- Hao Li (ORCID: https://orcid.org/0000-0001-6074-638X)
- Gerard M. O’Donoghue
Institutions
- Uppsala University (SE)
- Western University (CA)
- Nottingham University Hospitals NHS Trust (GB)
- University of Nottingham (GB)
- King's College London (GB)
- Guy's and St Thomas' NHS Foundation Trust (GB)
- University of Saskatchewan (CA)
- National Institute for Health and Care Research (GB)
- Queen's Medical Centre (GB)
- Nottingham Biomedical Research Centre (GB)
- Canadian Light Source (Canada) (CA)
- University of Sheffield (GB)
Publication Details
- Journal
- Scientific Reports
- Published
- 2024-11-05
- DOI
- https://doi.org/10.1038/s41598-024-74661-5
- Citations
- 4
- Primary Topic
- Hearing, Cochlea, Tinnitus, Genetics
- Type
- article
- Field-Weighted Citation Impact
- 1.44
Funders
- Canadian Light Source
- Stiftelsen Tysta Skolan
- Vetenskapsrådet
- Canadian Institutes of Health Research
- Natural Sciences and Engineering Research Council of Canada