Acquired sensorineural hearing loss in children: current research and therapeutic perspectives

摘要

The knowledge of mechanisms responsible for acquired sensorineural hearing loss in children, such as viral and bacterial infections, noiseexposure, 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 arestill challenging to develop a truly effective cochlear protection; however, the use of steroids, antioxidants, antiviral drugs and other smallmolecules 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 therapeuticperspectives include innovative strategies to transport drugs into the cochlea, such as molecules incorporated in nanoparticles that can bedelivered to a specific target. Innovative approaches also include the gene therapy designed to compensate for abnormal genes or to makeproteins by introducing genetic material into cells; finally, regenerative medicine (including stem cell approaches) may play a central rolein the upcoming years in hearing preservation and restoration even if its role in the inner ear is still debated.