Clin Exp Otorhinolaryngol.  2021 Feb;14(1):69-75. 10.21053/ceo.2019.01851.

Changes in Vestibular Symptoms and Function After Cochlear Implantation: Relevant Factors and Correlations With Residual Hearing

• Jang JH
• Kim H
• Choo OS
• Park HY
• Choung YH

• KMID: 2512883
• DOI: http://doi.org/10.21053/ceo.2019.01851

Abstract

Objectives
. The aim of this study was to evaluate vestibular function loss after cochlear implantation (CI) and the relationship between vestibular function and hearing changes.
Methods
. Seventy-five patients with CI were enrolled and divided into those with normal preoperative caloric function (group I) and those with a normal preoperative waveform in cervical vestibular evoked myogenic potential (c-VEMP) testing (group II). The relationship between hearing and changes in the vestibular system was analyzed preoperatively and at 3 and 6 months postoperatively.
Results
. In group I, unilateral weakness on the implanted side was detected in five (7.7%) and eight (12.3%) patients at 3 and 6 months post-CI, respectively. By 3 months post-CI, the total slow-phase velocity (SPV; warm and cold stimulations) was significantly different between the implanted and non-implanted sides (P=0.011), and the shift in total SPV from pre- to post-CI was significantly correlated with the average hearing threshold at 6 months post-CI. In group II, an abnormal c-VEMP was detected on the implanted side in six patients (16.2%) at 3 months post-CI, and in six patients (16.2%) at 6 months post-CI. Significant changes were noticed in the P1 and N1 amplitude at 3 months postCI (P=0.027 and P=0.019, respectively).
Conclusion
. Vestibular function and residual hearing function should be afforded equal and simultaneous consideration in terms of preservation.

Keyword

Cochlear Implantation; Vestibular Function Tests; Vertigo; Caloric Tests; Vestibular Evoked Myogenic Potential

Figure

• 

  Fig. 1. Flowchart of this study. CI, cochlear implantation; c-VEMP, cervical vestibular evoked myogenic potential.

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  Fig. 2. The frequency of new-onset subjective dizziness according to electrode type (A), approach (B), and steroid administration (C). At 3 months post-cochlear implantation, subjective dizziness was somewhat more frequent in patients who underwent cochleostomy (P=0.077), and significantly more frequent in patients who had not been administered steroids (P=0.009). The statistical analysis was performed using the chi-square test. RW, round window. *P<0.05.

• 

  Fig. 3. Comparison of the maximum slow-phase velocity (SPV) total (warm and cold stimulations) according to the electrode type (A), approach (B), and steroid administration (C). The SPV total was greater in ears with cochlear implantation (CI) using a flexible electrode (3 months, 43.3±23.0; 6 months, 55.3±26.4) than in ears with CI using a precurved electrode (3 months, 33.2±16.7; 6 months, 27.2±17.4) or a straight electrode (3 months, 32.9±18.8; 6 months, 34.5±19.4), and the difference was statistically significant at 6 months post-CI (P=0.007). The statistical analysis was performed using the t-test. RW, round window. *P<0.05, **P<0.01.

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  Fig. 4. Correlation between the average hearing threshold shift and the shift of the maximum slow-phase velocity (SPV) total (difference between the preoperative SPV total and postoperative SPV total) in group I. The statistical analysis was performed using correlation analysis.

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