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The inner ear assumes dual functionalities of auditory perception and equilibrium maintenance. The vestibule is the organ responsible for balance. This organ contains mechanoreceptors, specifically hair cells, endowed with stereocilia, which aid in deciphering information regarding the position and motion of our heads. Two intrinsic components, the utricle and saccule, help perceive head position, while the semicircular canals track head movement. Neurological messages initiated in the...
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Vestibular Function After Cochlear Implantation in Partial Deafness Treatment.

Magdalena Sosna-Duranowska1, Grazyna Tacikowska1, Elzbieta Gos1

  • 1Institute of Physiology and Pathology of Hearing, Warsaw, Poland.

Frontiers in Neurology
|June 7, 2021
PubMed
Summary

Cochlear implantation can cause vestibular damage, affecting up to 19.2% of patients. Preoperative vestibular assessment is crucial, especially for revision surgeries or those with prior balance issues, to manage risks.

Keywords:
caloric testcochlear implantationround window approachvestibular evoked miogenic potentialsvideo head impulse test

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Area of Science:

  • Otolaryngology
  • Neuroscience
  • Audiology

Background:

  • Cochlear implantation is a standard treatment for profound hearing loss.
  • Expanded indications for cochlear implantation necessitate a focus on vestibular protection.
  • The study addresses the risk of vestibular damage associated with cochlear implantation.

Purpose of the Study:

  • To assess the incidence of vestibular dysfunction following cochlear implantation.
  • To evaluate the relationship between hearing preservation and vestibular preservation.
  • To determine the necessity of preoperative otoneurological diagnostics in specific patient groups.

Main Methods:

  • 107 patients underwent preoperative and postoperative vestibular assessments.
  • Tests included cervical and ocular vestibular evoked myogenic potentials (cVEMP, oVEMP), caloric tests, and video head impulse tests (vHIT).
  • Assessments were performed at 1-6 months post-implantation.

Main Results:

  • Postoperative vestibular loss occurred in 19.2% (cVEMP), 17.4% (oVEMP), 11.6% (caloric), and 7.1% (vHIT lateral canal).
  • Vestibular preservation was statistically significantly associated with hearing preservation.
  • The risk of vestibular damage is not entirely eliminated despite hearing preservation techniques.

Conclusions:

  • Cochlear implantation carries an appreciable risk of vestibular damage.
  • Informed consent must include potential vestibular complications.
  • Preoperative otoneurological diagnostics are recommended for specific high-risk groups.