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Long-Term Vestibular Outcomes in Cochlear Implant Recipients
Kasper Møller Boje Rasmussen1,2, Niels West1,2, Luchen Tian1
1Department of Otorhinolaryngology Head and Neck Surgery and Audiology, Rigshospitalet, University Hospital of Copenhagen, Copenhagen, Denmark.
Frontiers in Neurology
|August 30, 2021
Summary
Cochlear implantation (CI) can lead to significant vestibular dysfunction, with tests showing worsening function 14 months post-surgery. However, most patients reported stable or improved dizziness symptoms despite these findings.
Area of Science:
- Otolaryngology
- Neuroscience
- Audiology
Background:
- Vestibular dysfunction is a common complication following cochlear implantation (CI), potentially causing severe vertigo.
- Existing literature on long-term vestibular outcomes after CI is limited, necessitating further investigation.
- This study addresses the need for comprehensive evaluation of vestibular function changes and long-term effects post-CI.
Purpose of the Study:
- To evaluate vestibular dysfunction before and after cochlear implantation in adult patients.
- To assess long-term vestibular outcomes up to 14 months post-implantation.
- To track changes in vestibular function using a battery of standardized tests.
Main Methods:
- Prospective observational longitudinal cohort study of 35 adult CI recipients (implanted 2018-2019, follow-up in 2021).
- Vestibular function evaluated at baseline (T0), 4 months (T1), and 14 months (T2) post-implantation.
- Tests included video head impulse test (vHIT), cervical vestibular evoked myogenic potentials (cVEMP), caloric irrigation, and Dizziness Handicap Inventory (DHI).
Main Results:
- Significant increases in unilateral weakness (19% to 40%) and semicircular canal hypofunction/areflexia (7 to 17 patients) were observed by T2 (p < 0.005).
- vHIT showed a significant increase in correction saccades (3 to 11 ears, p = 0.017), while cVEMP responses decreased (29% to 14%, p = 0.148).
- Dizziness Handicap Inventory (DHI) scores showed slight, non-significant increases, with most patients reporting unchanged or improved symptoms.
Conclusions:
- A significant deterioration in vestibular function, measured by vHIT, caloric irrigation, and cVEMP, occurs within 14 months post-CI.
- Vestibular function appears to plateau after the short-term postoperative period, with no significant further changes at the final follow-up.
- Despite objective vestibular dysfunction, the majority of patients experience stable or reduced subjective dizziness symptoms.
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