Vestibular Symptoms After Cochlear Implantation in Patients With Meniere Disease

To evaluate the impact of cochlear implantation (CI) on vestibular symptoms in patients with Meniere disease (MD).

Retrospective chart review.

Single tertiary referral center.

Patients with MD, who underwent CI between 2011 and 2024 and had documentation of preoperative and postoperative vestibular symptoms.

Placement of a cochlear implant for hearing rehabilitation.

Preoperative and postoperative subjective vestibular symptom severity.

Of 39 patients meeting inclusion criteria, 51% had moderate or severe vestibular symptoms preoperatively and 41% had mild symptoms. After CI, 28.2% had symptom improvement, 64.1% had stable symptoms, and 7.7% had symptom worsening. If preoperative symptom severity was mild or absent, compared with moderate or severe, patients were more likely to have stable symptoms (78.9% versus 50.0%, respectively) and less likely to experience symptom improvement (10.5% versus 45.0%, respectively), P = 0.038. Significantly more patients with moderate or severe preoperative symptoms had migraines compared with those with mild or absent symptoms (35.0% versus 5.3%, respectively, P = 0.044). Among patients with moderate or severe symptoms, those without comorbid migraines were more likely to experience symptom improvement compared with those with migraines (P = 0.0031).

Over 90% of MD patients who underwent CI in the MD-affected ear experienced vestibular symptom stability or improvement postoperatively. Patients with more severe preoperative symptoms were more likely to experience symptom improvement if they did not have comorbid migraines. These findings may have important implications for preoperative patient counseling and require validation in a larger patient cohort with objective vestibular symptom metrics.