Cochlear Implantation in Ménière's Disease

Introduction: Cochlear implantation has demonstrated benefit for restoring hearing in patients with Ménière's disease. We sought to examine disease and management factors that may influence postoperative speech performance and vertigo control.

A single-center retrospective chart review between 2010 and 2023 of patients with Ménière's disease receiving a cochlear implant (CI). The primary outcome was 1-year postoperative word recognition score on Consonant-Nucleus-Consonant (CNC) testing. Postoperative vertigo control was assessed as a secondary outcome. Variables including concurrent labyrinthectomy, pre- and postoperative Ménière's disease symptoms and treatments, duration of deafness, and hearing loss laterality were analyzed.

Twenty-five patients were identified over the study period. Of those, 9 (36%) also underwent labyrinthectomy; 6 (67%) were performed simultaneously with CI and 3 (33%) received a CI following surgical ablation. There was a statistically significant (p = 0.03) higher rate of bilateral Ménière's disease in the CI-only cohort (n = 9, 56%), compared to the cochlear implant and labyrinthectomy (CI + L) cohort (n = 1, 11%). There was also a higher rate of preoperative uncontrolled vertigo (n = 5, 56%) in the CI + L cohort compared to the CI-only cohort (n = 3, 20%), although this did not reach statistical significance (p = 0.08). The average pre- and postoperative CNC score for the CI + L cohort was 3.6 (SD 5.9) and 36.7 (SD 17.5), respectively, and 7.1 (SD 10.1) and 62.1 (SD 14.3) for the CI-only group. There was a statistically significant difference noted at most recent CNC follow-up testing (p = 0.01) between the CI + L and CI-only group.

Patients with Ménière's disease meeting CI candidacy criteria may undergo CI safely and achieve speech performance benefit. A trend toward worse performance in patients who undergo concurrent labyrinthectomy with CI compared to CI alone was seen which warrants further study.