Saccular function evolution related to cochlear implantation in hearing impaired children (original) (raw)
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Saccular Functıon in Chıldren wıth Cochlear Implant
The West Indian medical journal
The aim of this study was to evaluate vestibular evoked myogenic potential (VEMP) in patients with unilateral cochlear implant and normal hearing individuals. Methods: The study group consisted of 20 children (9 girls, 11 boys; mean age 8.70 ± 2.34 years; range 6-14 years) who underwent unilateral cochlear implantation. As controls, 12 healthy volunteer children (6 girls, 6 boys; mean age 8.91 ± 2.77 years; range 6-14 years) also participated in the study. Testing of VEMP was performed in cochlear implant patients and in the control group. Results: Vestibular evoked myogenic potential recorded in both ears of control individuals was normal, while VEMP was bilaterally obtained in 10 (50%) patients with cochlear implant. Two children (10%) showed no responses bilaterally. The mean P1 latencies and VEMP thresholds showed significant difference between implanted ears of patients with cochlear implant and the control group (p < 0.05). The mean VEMP thresholds showed significant difference between non-implanted ears of patients with cochlear implant and the control group (p < 0.05). Conclusions: Some patients with cochlear implant show a saccular dysfunction. The addition of the VEMP test to the cochlear implantation test battery may provide useful information about the saccular function before and after surgery.
Vestibular Function After Cochlear Implantation in Partial Deafness Treatment
Frontiers in Neurology, 2021
Introduction: Cochlear implantation is a fully accepted method of treating individuals with profound hearing loss. Since the indications for cochlear implantation have broadened and include patients with low-frequency residual hearing, single-sided deafness, or an already implanted ear (meaning bilateral cochlear implantation), the emphasis now needs to be on vestibular protection. Materials and Methods: The research group was made up of 107 patients operated on in the otorhinolaryngosurgery department: 59 females and 48 males, aged 10.4-80.2 years (M = 44.4; SD = 18.4) with hearing loss lasting from 1.4 to 56 years (M = 22.7; SD = 13.5). The patients underwent cVEMP, oVEMP, a caloric test, and vHIT assessment preoperatively, and, postoperatively, cVEMP and oVEMP at 1-3 months and a caloric test and vHIT at 4-6 months. Results: After cochlear implantation, there was postoperative loss of cVEMP in 19.2% of the patients, oVEMP in 17.4%, reduction of caloric response in 11.6%, and postoperative destruction of the lateral, anterior, and posterior semicircular canal as measured with vHIT in 7.1, 3.9, and 4% respectively. Conclusions: Hearing preservation techniques in cochlear implantation are connected with vestibular protection, but the risk of vestibular damage in never totally eliminated. The vestibular preservation is associated with hearing preservation and the relation is statistically significant. Informed consent for cochlear implantation must include information about possible vestibular damage. Since the risk of vestibular damage is appreciable, preoperative otoneurological diagnostics need to be conducted in the following situations: qualification for a second implant, after otosurgery (especially if the opposite ear is to be implanted), having a history of vestibular complaints, and when there are no strict audiological or anatomical indications on which side to operate.
Vestibular function after cochlear implant surgery
Cochlear Implants International, 2016
Introduction: Cochlear implantation (CI) has been reported to negatively affect vestibular function. The study of vestibular function has variably been conducted using different types of diagnostic tools. The combined use of modern, rapidly performing diagnostic tools could prove useful for standardization of the evaluation protocol. Methods: In a group of 28 subjects undergoing CI, the video head impulse test (vHIT), the cervical vestibular evoked myogenic potentials (cVEMP) and the short form of the Dizziness Handicap Inventory (DHI) questionnaire were investigated preoperatively and postoperatively (implant on and off) in both the implanted and the contralateral, nonimplanted ear. All surgeries were performed with a round window approach (RWA), except for 3 otosclerosis cases in which the extended RWA (eRWA) was used. Results: The vHIT of the lateral semicircular canal showed preoperative vestibular involvement in nearly 50% of the cases, while the 3 canals were contemporarily affected in only 14% of the cases. In all the hypofunctional subjects, cVEMP were absent. A low VOR gain in all of the investigated superior semicircular canals was found in 4 subjects (14%). In those subjects (21.7%) in whom cVEMP were preoperatively present and normal on the operated side, the absence of a response was postoperatively recorded. Discussion/Conclusion: The vestibular protocol applied in this study was found to be appropriate for distinguishing between the CI-operated ear and the nonoperated ear. In this regard, cVEMP was found to be more sensitive than vHIT for revealing a vestibular sufferance after CI, though without statistical significance. Finally, the use of RWA surgery apparently did not reduce the occurrence of signs of vestibular impairment.
Influence of cochlear implantation on the vestibular function
European Archives of Oto-Rhino-Laryngology, 2013
The aim of the present study was to examine the inXuence of cochlear implantation on vestibular function. The function of the horizontal semicircular canal, the saccular function, and the incidence of vestibular symptoms were assessed before and after cochlear implantation. Twenty unilaterally cochlear implant patients were evaluated preoperatively, 1 and 6 months postoperatively, with caloric testing with electronystagmography (ENG) recordings and vestibular evoked myogenic potentials (VEMP) testing. A medical history was taken from every subject, noting the presence or absence of vertigo before and after the operation. A possible correlation between the appearance of postoperative vertigo and age, sex, implant side, preoperative caloric results and VEMP status, and postoperatively recorded changes in caloric and VEMP testing was also investigated. A statistically signiWcant diVerence was found in the percentages of canal paresis (p = 0.01) and the percentages of VEMP waveform absence (p = 0.002) between the repeated measurements in the implanted side, whereas in the non-implanted side no diVerence was (p > 0.05) found. Four patients complained of postoperative vestibular symptoms. In three of them the symptoms lasted less than 6 months postoperatively, but the fourth patient was still dizzy 6 months after cochlear implantation. No correlation was found between the above-mentioned factors and the occurrence of postoperative vertigo. In conclusion, although changes of the peripheral vestibular function of the implanted side were recorded in our patients, permanent vertigo was rare. Predictive factors for the occurrence of postoperative vestibular symptoms could not be identiWed.
Vestibular function assessment in cochlear implant patients
The Egyptian Journal of Otolaryngology, 2019
Background Anatomical and embryological relations between cochlear and vestibular end organs predispose them to same noxious or developmental factors, thus these may affect either or both systems. Cochlear implantation being a widely used procedure for restoration of hearing in patients who are not candidates for regular amplification, may affect by different means the vestibular system. One of these factors include the surgical procedure. The aim of this study is to assess the vestibular function in cochlear implant candidates before surgery to exclude co-existing vestibular affection with the sensorineural hearing loss (SNHL). Reassessment after operation was done to determine the risk posed by surgery and for correlating the surgical approach to vestibular findings. Materials and methods The case series presented herein is of cochlear implant candidates who underwent full audiological and radiological assessment. Vestibular assessment was done before and after operation and inclu...
Evaluation of Saccular Function Pre-Post Cochlear Implant Surgery Using VEMPs
Iranian Rehabilitation Journal, 2015
Introduction In addition to anatomical proximity, the cochlear and vestibular system has close similarity in embryonic origin and development, microstructure, cellular and neuronal function. Therefore vestibular involvement is possible in patients with cochlear dysfunction and sensory neural hearing loss (SNHL) (1,2). Based on studies, there are vestibular dysfunctions in about 40 percent of children and adults with severe to profound SNHL (3,4). Cochlear Implant (CI) is a mean for patients with severe to profound hearing loss to retrieval of their hearing function. At least in preferable hearing conditions, most cases are able to understand speech only with CI device (5). Improved accessibility of auditory information which is absolutely vital for suitable speech and language development in children and for proper oral speech understanding in adults, has led to disregard studying side-effects and sometimes harmful effects of CI on other inner ear organs. Aside from hearing benefits...
Brazilian Journal of Otorhinolaryngology, 2017
Introduction: Cochlear implants are undeniably an effective method for the recovery of hearing function in patients with hearing loss. Objective: To describe the preoperative vestibular assessment protocol in subjects who will be submitted to cochlear implants. Methods: Our institutional protocol provides the vestibular diagnosis through six simple tests: Romberg and Fukuda tests, assessment for spontaneous nystagmus, Head Impulse Test, evaluation for Head Shaking Nystagmus and caloric test. Results: 21 patients were evaluated with a mean age of 42.75 ± 14.38 years. Only 28% of the sample had all normal test results. The presence of asymmetric vestibular information was documented through the caloric test in 32% of the sample and spontaneous nystagmus was an important clue for the diagnosis. Bilateral vestibular areflexia was present in four subjects, unilateral arreflexia in three and bilateral hyporeflexia in two. The Head Impulse Test was a significant indicator for the diagnosis of areflexia in the tested ear (p = 0.0001). The sensitized Romberg test using a foam pad was able to diagnose severe vestibular function impairment (p = 0.003). Conclusion: The six clinical tests were able to identify the presence or absence of vestibular function and function asymmetry between the ears of the same individual.
Preservation of vestibular function after scala vestibuli cochlear implantation
Auris Nasus Larynx, 2011
A 58-year-old man, in whom the cochlear implant (CI) had been inserted into the left ear, had right middle-ear cancer. The CI was removed immediately before receiving subtotal removal of right temporal bone. Four months later, the CI was again inserted in his left cochlea. Because of obliterated scala tympani, the 22 active electrodes of the CI were placed into the scala vestibuli. After the surgery, the patient complained that he experienced rotary vertigo and ''jumbling of vertical direction'' of objects on walking. Using rotation test, we evaluated vestibular function of remaining left ear. Numerous horizontal nystagmus beats were induced during earth-vertical axis rotation, whereas vertical downbeat nystagmus was scarcely induced during off-vertical axis rotation. The horizontal vestibulo-ocular reflex (VOR) was almost normally induced by sinusoidal stimulation at 0.8 Hz. These data suggest that the scala vestibuli insertion of CI would be not so invasive against the lateral semicircular canal. #
International Journal of Otorhinolaryngology and Head and Neck Surgery, 2021
Background: Cochlear implantation is an established procedure for patients with bilateral severe to profound sensorineural hearing loss. CI may, in some implantees, have a detrimental impact on vestibular function. Auditory brainstem implantation is a safe and effective procedure in children with bilateral cochlear and cochlear nerve aplasia. The aim of the study was to assess the impact of cochlear implantation and auditory brainstem implantation on the vestibular function. Methods: Three hundred and twenty patients who underwent CI surgery over a four years period from November 2016 to November 2020 were studied for symptoms of vestibular disturbance. Twenty three patients complained of giddiness and underwent vestibular function testing including videooculography, caloric test and vestibular evoked myogenic potentials. 48 patients with cochlear and cochlear nerve aplasia underwent ABI surgery from September 2009 to March 2019. The correlation between the size of the flocculus and...