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Vestibular and Balance Impairment Contributes to Cochlear Implant Failure in Children

Nikolaus E Wolter1, Karen A Gordon, Blake C Papsin

  • 1*Department of Otolaryngology-Head & Neck Surgery, University of Toronto, Toronto; †Archie's Cochlear Implant Laboratory and ‡Department of Otolaryngology-Head & Neck Surgery, The Hospital for Sick Children, Toronto, Ontario, Canada.

Otology & Neurotology : Official Publication of the American Otological Society, American Neurotology Society [And] European Academy of Otology and Neurotology
|April 9, 2015
PubMed

Insights

Vestibular and balance problems significantly increase the risk of cochlear implant (CI) failure in children. Early detection and treatment of these issues are crucial for preventing implant failure and supporting auditory development.

Area of Science:

  • Pediatric Otolaryngology
  • Neuroscience
  • Audiology

Background:

  • Cochlear implant (CI) failure can significantly impact a child's auditory development and speech acquisition.
  • The role of vestibular and balance dysfunction in CI outcomes is not fully understood.
  • Identifying risk factors for CI failure is essential for improving long-term device efficacy.

Purpose of the Study:

  • To investigate the association between vestibular and balance dysfunction and cochlear implant (CI) failure in pediatric patients.
  • To compare vestibular function and balance performance in children with CI failure versus those without.
  • To determine if vestibular end-organ dysfunction is a risk factor for CI failure.

Main Methods:

  • Retrospective case review of 35 children with CI failure and 165 controls at a tertiary referral center.
  • Assessment of horizontal canal function using caloric tests, rotational chair, and video Head Impulse Testing (vHIT).
  • Evaluation of saccular function with vestibular evoked myogenic potentials (VEMPs) and balance using the Bruininks-Oseretsky Test (BOT-2).

Main Results:

  • Children with CI failure showed significantly higher rates of abnormal horizontal canal function (caloric: 81% vs. 47%; rotational/vHIT: 71% vs. 35%).
  • Absence of bilateral horizontal canal function was associated with a 7.6-fold increased odds of CI failure.
  • Abnormal saccular function (81% vs. 46%) and poorer balance (BOT-2 scores: 7.8 vs. 12.2) were also significantly more prevalent in children with CI failure.

Conclusions:

  • Vestibular end-organ dysfunction is a significant risk factor for CI failure in children.
  • Impaired balance is a key consequence of vestibular dysfunction and is linked to CI failure.
  • Early identification and management of vestibular and balance impairments may prevent CI failures and mitigate auditory deprivation.
Abstract

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