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Vestibular impairments pre- and post-cochlear implant in children

Etienne Jacot1, Thierry Van Den Abbeele, Hopital Robert Debre

  • 1Département d'ORL, Unité de Vestibulométrie, Hopital Pédiatrique Robert Debré, Paris, France.

International Journal of Pediatric Otorhinolaryngology
|December 23, 2008
PubMed

Insights

Half of pediatric cochlear implant candidates have vestibular deficits. Cochlear implants can alter vestibular function, necessitating pre-implant testing to guide device placement and monitor for changes.

Area of Science:

  • Otolaryngology
  • Neuroscience
  • Pediatric Audiology

Background:

  • Sensorineural hearing loss (SNHL) is a common condition in children.
  • Vestibular impairments are frequently associated with SNHL.
  • Cochlear implantation is a standard treatment for profound SNHL in children.

Purpose of the Study:

  • To determine the prevalence and types of vestibular impairments in pediatric SNHL patients.
  • To evaluate the impact of cochlear implants on pre-existing vestibular function.

Main Methods:

  • Retrospective and prospective study design.
  • Comprehensive vestibular testing (clinical exam, bicaloric, rotation, VEMPs) in 224 pediatric SNHL candidates.
  • Follow-up vestibular assessment in 89 patients post-cochlear implantation.

Main Results:

  • 50% of SNHL patients exhibited normal vestibular function; significant deficits (areflexia, hypoexcitability) were common.
  • 51% of implanted patients showed changes in vestibular function within 3 months post-surgery.
  • Ipsilateral areflexia occurred in 10% of follow-up patients, with some partial recovery over time.

Conclusions:

  • Pre-implant vestibular assessment is crucial for pediatric cochlear implant candidates.
  • Testing aids in selecting the optimal ear for implantation and establishes baseline for monitoring.
  • Recommended tests include head thrust, bicaloric, and VEMP assessments.
Abstract

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