Background: The success of cochlear implantation may be further improved by minimizing implantation trauma. The\nphysical trauma of implantation and subsequent immunological sequelae can affect residual hearing and the viability\nof the spiral ganglion. An ideal electrode should therefore decrease post-implantation trauma and provide support to\nthe residual spiral ganglion population. Combining a flexible electrode with cells producing and releasing protective\nfactors could present a potential means to achieve this. Mononuclear cells obtained from bone marrow (BM-MNC)\nconsist of mesenchymal and hematopoietic progenitor cells. They possess the innate capacity to induce repair of\ntraumatized tissue and to modulate immunological reactions.\nMethods: Human bone marrow was obtained from the patients that received treatment with biohybrid electrodes.\nAutologous mononuclear cells were isolated from bone marrow (BM-MNC) by centrifugation using the Regenlabââ??¢\nTHT-centrifugation tubes. Isolated BM-MNC were characterised using flow cytometry. In addition, the release of\ncytokines was analysed and their biological effect tested on spiral ganglion neurons isolated from neonatal rats. Fibrin\nadhesive (Tissealââ??¢) was used for the coating of silicone-based cochlear implant electrode arrays for human use in order\nto generate biohybrid electrodes. Toxicity of the fibrin adhesive and influence on insertion, as well on the cell coating,\nwas investigated. Furthermore, biohybrid electrodes were implanted in three patients.\nResults: Human BM-MNC release cytokines, chemokines, and growth factors that exert anti-inflammatory and\nneuroprotective effects. Using fibrin adhesive as a carrier for BM-MNC, a simple and effective cell coating procedure for\ncochlear implant electrodes was developed that can be utilised on-site in the operating room for the generation of\nbiohybrid electrodes for intracochlear cell-based drug delivery. A safety study demonstrated the feasibility of autologous\nprogenitor cell transplantation in humans as an adjuvant to cochlear implantation for neurosensory restoration.\nConclusion: This is the first report of the use of autologous cell transplantation to the human inner ear. Due to the\nsimplicity of this procedure, we hope to initiate its widespread utilization in various fields
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