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Published on: August 30, 2019
The effects of cochlear implantation on vestibular function
Thuy-Anh N Melvin1, Charles C Della Santina, John P Carey
1Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland 21205, USA.
Summary
Cochlear implantation (CI) poses a small risk of labyrinthine injury, comparable to other CI risks. Patients should be informed about potential balance function effects, especially with "only balancing ear" CI.
Area of Science:
- Otolaryngology
- Neuroscience
- Audiology
Background:
- Cochlear implantation (CI) is a common procedure for severe to profound hearing loss.
- Potential risks associated with CI include labyrinthine injury affecting vestibular function.
- Understanding the incidence and impact of CI on balance is crucial for patient counseling.
Purpose of the Study:
- To determine the risk of cochlear implantation (CI) to the labyrinth.
- To assess the impact of CI on vestibular function using various clinical tests.
- To evaluate the utility of the clinical head impulse test (cHIT) in detecting vestibular deficits post-CI.
Main Methods:
- Prospective cohort study at an academic tertiary referral center.
- 36 adult CI candidates underwent comprehensive vestibular function testing before and after CI.
- Tests included quantitative 3-dimensional head impulse test (qHIT), cHIT, electronystagmography, vestibular-evoked myogenic potentials, and Dizziness Handicap Inventory.
Main Results:
- 1 of 28 ears showed reduced function on qHIT post-CI.
- cHIT demonstrated 44% sensitivity and 94% specificity for severe vestibular hypofunction.
- Vestibular-evoked myogenic potentials indicated changes in 5 of 16 ears; Dizziness Handicap Inventory showed mixed results.
Conclusions:
- The rate of labyrinthine injury from CI is small but comparable to other CI risks.
- CI candidates should be educated about potential balance function risks.
- cHIT is a valuable tool for pre-CI screening of vestibular function.
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