Related Experiment Video
Updated: Apr 28, 2026
Electrically Evoked Stapedius Reflex Measurements in Cochlear Implantation and Its Application in the Postoperative Fitting Process
Published on: June 21, 2024
Vestibular evoked myogenic potentials in children after cochlear implantation
George Psillas1, Alexandra Pavlidou1, Nikos Lefkidis1
11st Academic ENT Department, Aristotle University of Thessaloniki, AHEPA Hospital, 1, Stilponos Kyriakidi St., GR 546 36 Thessaloniki, Greece.
Insights
Cochlear implantation in children under 5 may damage the saccule, indicated by absent vestibular evoked myogenic potentials (VEMPs). Some recovery on the non-implanted side is possible, with children compensating for vestibular deficits.
Area of Science:
- Pediatric Otolaryngology
- Neuroscience
- Vestibular System Research
Background:
- Unilateral cochlear implantation is a common procedure for hearing loss in children.
- The impact of cochlear implantation on the vestibular system, particularly the saccule, is not fully understood in young children.
- Vestibular evoked myogenic potentials (VEMPs) are a key tool for assessing saccular function.
Purpose of the Study:
- To evaluate the effect of unilateral cochlear implantation on the vestibular system in children under 5 years old.
- To assess saccular function using air-conduction VEMPs before and after cochlear implantation.
- To investigate VEMPs responses in both implanted and unimplanted ears, with the cochlear implant on and off.
Main Methods:
- A study involving 10 children under 5 who underwent cochlear implantation and 8 age-matched normal-hearing children.
- VEMPs were recorded preoperatively, 10 days post-surgery, and 6 months post-surgery.
- Evaluation included both the implanted and contralateral ears, with the device in both on and off states.
Main Results:
- Preoperatively, 60% of children had abnormal VEMPs in both ears.
- No VEMPs responses were observed in the implanted ear post-surgery.
- VEMPs were largely absent in the unimplanted ear, with partial recovery noted at 6 months in some cases, irrespective of cochlear implant status.
Conclusions:
- Cochlear implantation in young children may lead to significant saccular damage, evidenced by the disappearance of VEMPs.
- Some recovery of saccular function on the unimplanted side is possible post-implantation.
- Children may exhibit effective compensation for vestibular deficits, explaining the lack of apparent clinical symptoms despite saccular injury.
Objective:
The aim of this study was to report the effect of unilateral cochlear implantation to vestibular system using vestibular evoked myogenic potentials (VEMPs) by air-conduction in a sample of children aged less than 5 years.
Materials:
This study consisted of 10 children (6 boys and 4 girls), who underwent cochlear implantation surgery at our clinic, and 8 normal hearing children (5 boys and 3 girls) matched for age. The VEMPs were performed before, 10 days, and 6 months after surgery. Both the implanted and unimplanted ears of each child were evaluated, with the cochlear implant both off and on.
Results:
Preoperatively, six (60%) children had abnormal VEMPs responses on both ears. In the postoperative sessions, no child showed any VEMPs response on the implanted side. The VEMPs were not recorded on the unimplanted side either, except for one case. At 6 months, the VEMPs response on the unimplanted side of three children became normal when the cochlear implant was on, and in two children with the device off.
Conclusion:
In the postoperative 6-month-period, the disappearance of VEMPs suggests that the saccule of children can be extensively damaged following cochlear implantation. A recovery of VEMPs can take place on the unimplanted side, with the cochlear implant both on and off. Despite this saccular injury, the absence of clinical signs in children could be explained by their ability to effectively compensate for such vestibular deficits.
