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Published on: August 30, 2019

Disturbance of vestibular function attributable to cochlear implantation in children

Greg Licameli1, Guangwei Zhou, Margaret A Kenna

  • 1Department of Otolaryngology and Communication Enhancement, Children's Hospital Boston, Boston, Massachusetts, USA.

The Laryngoscope
|February 11, 2009
PubMed

Insights

Cochlear implantation (CI) significantly impacts vestibular function in children, with 60% showing impairment. Preoperative vestibular evaluation is crucial for managing potential hearing loss and balance issues.

Area of Science:

  • Otolaryngology
  • Pediatric Audiology
  • Neuroscience

Background:

  • Vestibular impairment is a concern in children with cochlear implants (CI).
  • Awareness of post-implantation vestibular disturbance is critical for patient management.

Purpose of the Study:

  • To determine the prevalence and severity of vestibular impairment in pediatric CI recipients.
  • To highlight the importance of addressing vestibular dysfunction following cochlear implantation.

Main Methods:

  • A cohort study was conducted at a pediatric tertiary care facility.
  • Vestibular evaluation included vestibulo-ocular reflex (VOR), computerized dynamic posturography (CDP), and vestibular evoked myogenic potential (VEMP) testing in 42 CI patients.
  • Pre- and post-implantation VEMP measurements were compared in 19 newly implanted patients.

Main Results:

  • Vestibular impairment was observed in 60% of pediatric CI patients, manifesting as reduced VOR gain, postural instability, and altered VEMP thresholds/amplitudes.
  • Over 80% of subjects showed changes in saccular function post-implantation, as indicated by VEMP.
  • The degree of functional impairment varied among individuals.

Conclusions:

  • Cochlear implantation can negatively affect vestibular function, particularly in bilateral cases.
  • Preoperative vestibular assessment is essential for identifying at-risk children.
  • Vestibular evoked myogenic potential (VEMP) and vestibulo-ocular reflex (VOR) testing are valuable screening tools for CI candidates.
  • Optimizing CI electrode design and surgical techniques may reduce inner ear trauma.
Abstract

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