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Dexamethasone-Eluting Cochlear Implant Electrode (CIDEX)

Primary Purpose

Hearing Loss, Sensorineural, Sensorineural Hearing Loss

Status
Completed
Phase
Not Applicable
Locations
Germany
Study Type
Interventional
Intervention
CIDEXEL implant
Sponsored by
MED-EL Elektromedizinische Geräte GesmbH
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional device feasibility trial for Hearing Loss, Sensorineural

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Minimum age of eighteen (18) years at time of enrolment.
  • Severe to profound sensorineural hearing loss on the ipsilateral ear.
  • A functional auditory nerve in the ear to be implanted.
  • Subjects reporting to having used an optimally fit hearing aids for a minimum of three months before the decision that a cochlear implant (CI) is the preferential option.
  • Cochlea anatomy compatible with the insertion of a +FLEX28 electrode array.
  • Compatibility with a soft surgery approach as per clinical practice at the site.
  • Post-lingual hearing impairment.
  • Subject fulfilling indication criteria for a CI according to the local professional standards, as reported by the implanting surgeon.
  • General health condition, psychological and emotional condition deemed compatible with the treatment and tests performed in this study and realistic expectations, as deemed appropriate by the implanting surgeon.
  • Signed and dated informed consent before the start of any study-specific procedure.

Exclusion Criteria:

  • Lack of compliance with any inclusion criterion.
  • Previously having received a cochlear implant on the ear chosen for placing the IMD (Investigational Medical Device).
  • Evidence of ossification or any other cochlear anomaly that might prevent complete insertion of the electrode array or might cause increased risk of infection (e.g. dysplastic cochlea), as confirmed by medical examination and/or as per CT/MRT (Computed Tomography/Magnetic Resonance Tomography).
  • Evidence of anatomic abnormalities that would prevent appropriate placement of the stimulator housing in the bone of the skull.
  • Evidence of otosclerosis.
  • Known allergic reaction or intolerance to the materials used in the implant (including medical grade silicone, platinum, iridium, parylene c, dexamethasone).
  • Known absence of cochlear development or if the cause of deafness is non-functionality of the auditory nerve and/or the upper auditory pathway.
  • Evidence of active external or middle ear infection or history of recurrent middle ear infection in the ear to be implanted.
  • Evidence of perforated tympanic membrane in the ear to be implanted.
  • Patient reporting immunosuppressive therapy or corticosteroids therapy in the 4 weeks before enrolment.
  • Evidence of concomitant use of medicinal substances that, in the opinion of the investigator, could alter the therapeutic efficacy of dexamethasone.
  • Unwillingness or inability of the candidate to comply with all investigational requirements.
  • Evidence of medical contraindications to surgery of the middle and inner ear and anaesthesia.
  • Additional disabilities that would prevent or restrict participation in the audiological and medical evaluations required of the clinical investigation.

Sites / Locations

  • MHH - Medizinische Hochschule Hannover

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

single arm - treatment

Arm Description

All subjects will be implanted with the investigational device.

Outcomes

Primary Outcome Measures

Adverse Events
Safety profile of the device which will be evaluated through the analysis of adverse events

Secondary Outcome Measures

IFT (Impedance Field Telemetry) - impedance
Impedance Field Telemetry and derived values
Electrically Evoked Compound Action Potential
Electrically Evoked Compound Action Potential and derived values
MCL (Maximum Comfortable Loudness)
Maximum Comfortable Loudness Levels and Thresholds
THR (Threshold)
Thresholds
PTA (Pure Tone Audiometry) Audiometrical values
Results from PTA assessment
Hearing Preservation rate
Rate of Hearing Preservation according to Skarżyński et al.
HSM (Hochmair-Schulz-Moser Sentence) Test
Speech test in noise
Questionnaire
Surgical feedback questionnaire

Full Information

First Posted
June 16, 2020
Last Updated
May 31, 2022
Sponsor
MED-EL Elektromedizinische Geräte GesmbH
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1. Study Identification

Unique Protocol Identification Number
NCT04450290
Brief Title
Dexamethasone-Eluting Cochlear Implant Electrode
Acronym
CIDEX
Official Title
Dexamethasone-Eluting Cochlear Implant Electrode (CIDEXEL): A First in Human Study
Study Type
Interventional

2. Study Status

Record Verification Date
May 2022
Overall Recruitment Status
Completed
Study Start Date
June 30, 2020 (Actual)
Primary Completion Date
May 5, 2022 (Actual)
Study Completion Date
May 5, 2022 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
MED-EL Elektromedizinische Geräte GesmbH

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
A newly developed MED-EL Cochlear Implant incorporates the anti-inflammatory agent dexamethasone (DEX) into the electrode array. The passive elution of DEX during the post-implantation period has the purpose of counteracting the increase of the post-operative impedance induced by the insertion trauma. The aim of this clinical investigation is to obtain a first experience in use of the investigational device in the adult clinical population, and to initially assess tools, techniques and performance outcome measures that may be considered in future clinical studies of similar devices.
Detailed Description
The principal objective of this study is to exploratively investigate the safety profile of the device which will be evaluated through the analysis of adverse events during the follow-up period. For the study to be considered a success, the results of the adverse event analysis shall never cause an unbalanced risk vs. benefit assessment. The secondary objectives of this study aim at investigating the usefulness of possible outcome measures in evaluating the performance of the device.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Hearing Loss, Sensorineural, Sensorineural Hearing Loss

7. Study Design

Primary Purpose
Device Feasibility
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Model Description
First-in-human, single-arm, exploratory, open-label, prospective, longitudinal, monocentric study
Masking
None (Open Label)
Allocation
N/A
Enrollment
10 (Actual)

8. Arms, Groups, and Interventions

Arm Title
single arm - treatment
Arm Type
Experimental
Arm Description
All subjects will be implanted with the investigational device.
Intervention Type
Device
Intervention Name(s)
CIDEXEL implant
Intervention Description
The newly developed MED-EL Cochlear Implant incorporates the anti-inflammatory agent dexamethasone (DEX) into the electrode array. The passive elution of DEX during the post-implantation period has the purpose of counteracting the increase of the post-operative impedance induced by the insertion trauma.
Primary Outcome Measure Information:
Title
Adverse Events
Description
Safety profile of the device which will be evaluated through the analysis of adverse events
Time Frame
10 months
Secondary Outcome Measure Information:
Title
IFT (Impedance Field Telemetry) - impedance
Description
Impedance Field Telemetry and derived values
Time Frame
10 months
Title
Electrically Evoked Compound Action Potential
Description
Electrically Evoked Compound Action Potential and derived values
Time Frame
10 months
Title
MCL (Maximum Comfortable Loudness)
Description
Maximum Comfortable Loudness Levels and Thresholds
Time Frame
10 months
Title
THR (Threshold)
Description
Thresholds
Time Frame
10 months
Title
PTA (Pure Tone Audiometry) Audiometrical values
Description
Results from PTA assessment
Time Frame
10 months
Title
Hearing Preservation rate
Description
Rate of Hearing Preservation according to Skarżyński et al.
Time Frame
10 months
Title
HSM (Hochmair-Schulz-Moser Sentence) Test
Description
Speech test in noise
Time Frame
10 months
Title
Questionnaire
Description
Surgical feedback questionnaire
Time Frame
10 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Minimum age of eighteen (18) years at time of enrolment. Severe to profound sensorineural hearing loss on the ipsilateral ear. A functional auditory nerve in the ear to be implanted. Subjects reporting to having used an optimally fit hearing aids for a minimum of three months before the decision that a cochlear implant (CI) is the preferential option. Cochlea anatomy compatible with the insertion of a +FLEX28 electrode array. Compatibility with a soft surgery approach as per clinical practice at the site. Post-lingual hearing impairment. Subject fulfilling indication criteria for a CI according to the local professional standards, as reported by the implanting surgeon. General health condition, psychological and emotional condition deemed compatible with the treatment and tests performed in this study and realistic expectations, as deemed appropriate by the implanting surgeon. Signed and dated informed consent before the start of any study-specific procedure. Exclusion Criteria: Lack of compliance with any inclusion criterion. Previously having received a cochlear implant on the ear chosen for placing the IMD (Investigational Medical Device). Evidence of ossification or any other cochlear anomaly that might prevent complete insertion of the electrode array or might cause increased risk of infection (e.g. dysplastic cochlea), as confirmed by medical examination and/or as per CT/MRT (Computed Tomography/Magnetic Resonance Tomography). Evidence of anatomic abnormalities that would prevent appropriate placement of the stimulator housing in the bone of the skull. Evidence of otosclerosis. Known allergic reaction or intolerance to the materials used in the implant (including medical grade silicone, platinum, iridium, parylene c, dexamethasone). Known absence of cochlear development or if the cause of deafness is non-functionality of the auditory nerve and/or the upper auditory pathway. Evidence of active external or middle ear infection or history of recurrent middle ear infection in the ear to be implanted. Evidence of perforated tympanic membrane in the ear to be implanted. Patient reporting immunosuppressive therapy or corticosteroids therapy in the 4 weeks before enrolment. Evidence of concomitant use of medicinal substances that, in the opinion of the investigator, could alter the therapeutic efficacy of dexamethasone. Unwillingness or inability of the candidate to comply with all investigational requirements. Evidence of medical contraindications to surgery of the middle and inner ear and anaesthesia. Additional disabilities that would prevent or restrict participation in the audiological and medical evaluations required of the clinical investigation.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Thomas Lenarz, Prof. Prof. h. c. Dr. med.
Organizational Affiliation
Hals-Nasen-Ohrenklinik der Medizinischen Hochschule Hannover
Official's Role
Principal Investigator
Facility Information:
Facility Name
MHH - Medizinische Hochschule Hannover
City
Hannover
ZIP/Postal Code
30625
Country
Germany

12. IPD Sharing Statement

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Dexamethasone-Eluting Cochlear Implant Electrode

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