Related Experiment Video
Updated: Jul 16, 2026
Performing Intracochlear Electrocochleography During Cochlear Implantation
Published on: March 8, 2022
The impact of the video head impulse test on side determination in cochlear implantation surgery
Ryan P McKenna1, Samantha Taylor1, Colin G Leonard2
1School of Medicine, Dentistry and Biomedical Sciences, Queen's University, Belfast, Northern Ireland.
Objectives:
To evaluate the impact of the Video Head Impulse Test (vHIT) on side determination in cochlear implantation (CI) surgery.
Methods:
Retrospective analysis of vHIT results from 75 adult sequential CI recipients at a regional auditory implant centre between January 2023 and April 2024. Patients were grouped by side of implantation (right, n = 40; left, n = 35). vHIT results were assessed through clinical assessment and normative comparison. For categorical analysis, patients were classified as having their 'better' or 'worse' balance ear implanted, or normal or equally abnormal function bilaterally. Clinical assessment was based on clinician interpretation of vHIT graphs, while normative comparison applied established gain thresholds and corrective saccades to define abnormality.
Results:
Neither clinical nor normative analysis demonstrated a significant association between vHIT findings and the side implanted. This is supported by continuous gain value analysis showing no statistical differences between cohorts.
Discussion:
Although implanting the ear with poorer vestibular function may minimise postoperative disequilibrium, vestibular testing is not universally performed nor advocated for. Other factors, including patient preference and anatomical constraints, may have considerable influence on side selection.
Conclusion:
Concerns about implanting the 'better' balance ear are valid, however, vHIT does not outweigh other factors when determining CI sidedness.
