Compensated Vestibular Dysfunction Post Cochlear Implantation in Children with Sensorineural Hearing Loss: A...

Area of Science:

• Otolaryngology
• Neuroscience
• Pediatric Audiology

Background:

• Cochlear implantation (CI) is a common treatment for sensorineural hearing loss in children.
• Surgical instrumentation during CI carries a risk of inducing vestibular dysfunction.
• Understanding this risk is crucial for informed patient consent and surgical planning.

Purpose of the Study:

• To identify and quantify compensated vestibular dysfunction following cochlear implantation in pediatric patients.
• To assess the incidence of surgically induced vestibular changes after CI.
• To inform clinical practice regarding pre- and post-operative vestibular assessment.

Main Methods:

• Vestibular function was evaluated using monothermal warm air caloric testing before and after cochlear implantation.
• Nystagmus slow-phase velocity was recorded using a head-mounted camera and SYNAPSYS Ulmer VNG software.
• Monothermal caloric asymmetry (MCA) exceeding 15% was defined as canal paresis, indicating vestibular dysfunction.

Main Results:

• A statistically significant incidence of 16.66% for compensated vestibular dysfunction was observed post-CI (p=0.02).
• The results indicated a worsening of canal paresis, consistent with vestibular dysfunction.
• This suggests a notable risk of surgically induced vestibular impairment.

Conclusions:

• Pediatric cochlear implantation is associated with a significant risk of developing compensated vestibular dysfunction.
• Pre- and post-operative vestibular system evaluation is recommended for all children undergoing CI.
• Careful consideration is advised before proceeding with bilateral cochlear implantation in a single surgical session.