**1. Introduction**

In the past cochlear implantation was a "gold standard" treatment method for patients who suffer from hearing impairment and dedicated only for patients totally deaf. During the last 15 years, cochlear implantation became available also as a treatment for different types of hearing impairment. Regardless of surgical technique for cochlear implantation (cochleostomy or an approach through the round window), specialized centers have now introduced the comprehensive analysis of

the nonsurgical factors that could contribute to improve rates of hearing preservation in preoperative, during surgery, or in postoperative period in patients who suffer from partial deafness. One of the approaches of many leading research centers is using pharmacotherapy (glucocorticoids) as a factor which may improve hearing functions following cochlear implantation [1, 2]. Glucocorticoids play an important role in pharmacotherapy of many different otorhinolaryngological diseases, such as Meniere's disease, sudden sensorineural hearing loss (SSNHL), and tinnitus, and as a part of otorhinolaryngological procedures in surgeries (e.g., cochlear implantation) [3, 4]. The effects of treatment listed diseases are different and mainly depend on treatment results, adverse effects of used medications, and additional pharmacological treatment that was used during treatment. Unfortunately, the side effects of glucocorticoids are serious, and as the result, sometimes pharmacotherapy has to be stopped, and discontinuation of therapy is the only solution.

On the one hand, insertion of specific electrode of cochlear implant requires perfection in surgical techniques, but on the other it is difficult to do perfectly. Clinically approved algorithm of corticosteroid therapy (local or systematic) is discussed as one factor in reducing oxidative stress, an inflammatory reaction, and as a result apoptosis of hearing cells. A major challenge in effective administration and delivery medicines is the *blood-labyrinth barrier* (BLB) and physical inaccessibility of the inner ear, especially the apical part of the cochlea. It seems to be crucial especially for patients who suffer from partial deafness (PD) (apical hair cells are responsible for receiving low frequencies).
