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Dizziness and vestibular function before and after cochlear implantation.

Yoon Chan Rah1,2, Joo Hyun Park1, Jae Hong Park1

  • 1Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, 166, Gumi-ro, Bundang-gu, Seongnam, Gyeonggi, 463-707, Republic of Korea.

European Archives of Oto-Rhino-Laryngology : Official Journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : Affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery
|March 23, 2016
PubMed
Summary

Cochlear implantation (CI) can cause vestibular problems, with 27.3% of patients experiencing dizziness post-surgery. Careful pre-operative vestibular assessment is crucial, especially for single-sided or bilateral CI candidates.

Keywords:
Cochlear implantationDizzinessVestibular function

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Area of Science:

  • Otorhinolaryngology
  • Neuroscience
  • Audiology

Background:

  • Vestibular dysfunction is a potential complication following cochlear implantation (CI).
  • Understanding the incidence and characteristics of post-CI vestibular symptoms is essential for patient management.
  • Pre-operative vestibular status influences surgical decisions, particularly in cases of unilateral or bilateral hearing loss.

Purpose of the Study:

  • To categorize and analyze vestibular problems occurring after cochlear implantation.
  • To correlate clinical symptoms with objective changes in vestibular function.
  • To identify potential etiologies for post-implantation vestibular disturbances.

Main Methods:

  • Analysis of vestibular function in 62 patients (66 ears) undergoing cochlear implantation.
  • Categorization of vestibular symptoms based on clinical course and timing.
  • Objective vestibular function assessment using caloric and video head impulse tests.
  • Comparison of pre- and post-operative vestibular function parameters.

Main Results:

  • Pre-operative vestibular function was normal in 47%, unilaterally hypofunctional in 21.2%, and bilaterally hypofunctional in 31.8%.
  • Postoperative dizziness occurred in 27.3% of patients, with varied presentations including transient, prolonged, and recurrent episodic symptoms.
  • Implanted ears showed a significant decrease in maximal slow-phase velocities (SPVs) post-implantation (22.70 to 12.55°/s, p=0.004).

Conclusions:

  • Cochlear implantation can lead to significant changes in vestibular function, manifesting as various dizziness symptoms.
  • The type and timing of vestibular symptoms provide clues to their underlying etiology, such as benign positional paroxysmal vertigo or endolymphatic hydrops.
  • Thorough pre-operative vestibular evaluation is critical for informed decision-making regarding cochlear implantation, especially in patients with compromised vestibular function.