Accessing the Scala Media of the Inner Ear with Robot Assistance
Accessing the scala media of the cochlea would permit the delivery of drugs, growth factors, gene therapy vectors and cells in order to treat hearing loss of cochlear origin. Many forms of hearing loss begin with trauma to the acoustic hair cell receptors, which in turn, initiates a downstream cascade of events that damages the neurons conducting signals into the brain. The goal of this invention is to facilitate treatment at the hair cell-neuron junction. This sensorineural hearing loss is the main cause of age-related hearing loss. Because of the extremely small dimensions of the cochlea, surgeons are currently unable to obtain surgical access to the scala media. However, with the assistance of high-resolution imaging and steadying devices, either actively or passively controlled, to improve precision, accessing the scala media is possible. Description (Set) Proposed Use (Set) The purpose of our patent?accessing the scala media of the inner ear has primary application in the treatment of hearing loss. Hearing loss primarily occurs as a result of hair cell loss in the scala media of the inner ear. Hearing loss from hair cell damage is an enormous problem. In the United States, 28 million people suffer from hearing loss. Furthermore, people are losing their hearing earlier in life. Currently, 30% of adults 65 years and older and 50% of adults 75 years and older suffer from age-related hearing loss. Hearing aids do not treat the disease loss of hair cells but rather attempt to amplify sound as compensation for hair cell loss. However, only 25% of those who could benefit from a hearing aid actually use one. In other words, 75% of those with significant hearing loss are untreated. Much of that under-treatment results from the marginal benefit that people feel they derive from hearing aids. Nevertheless, even with only 25% of the population being served, hearing aids are a $1.5 billion market worldwide. Directly accessing the scala media of the inner ear would potentiate treatments for hear cell loss, of which there are currently none. It would do this in two ways. First, because researchers cannot access hair cells directly to develop therapies for hair cell regeneration, our application would be a critical enabler of basic research. Second, once therapies are developed, our application would also be the means of delivery for treating patients. There are a number of promising approaches whose potential could be greatly enhanced by the ability to access directly the scala media where the inner hair cells live. Candidate treatments for hair cell damage fall into the following general categories: growth factors, gene therapy vectors and cell lines. A number of growth factors, either alone or in combination, have been studied for their ability to promote inner hair cell repair. These include transforming growth factor alpha (TGF-), insulin-like growth factor (IGF), retinoic acid, neurotrophin-3, nerve growth factor, brain-derived nerve growth factor, glial-derived neurotrophic factor, and epithelial growth factor (EGF). Gene therapy approaches are also being studied for inner hair cell repair. Several gene therapy vectors, such as the herpes virus, adenovirus and adeno-associated virus, have been shown to transduce inner hair cells successfully. Furthermore, although no suitable cell-lines have yet been identified, transplantation of inner hair cell precursors has been suggested as another treatment for hearing loss due to inner hair cell damage. The ability to deliver these growth factors, gene therapy vectors and cells directly to the scala media of the cochlea could potentially revolutionize the treatment of hearing loss due to inner hair cell damage. Therefore, we feel the potential commercial importance our patent is enormous.
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