Open AccessEarly Assessment of Vestibular Function after Unilateral Cochlear Implant Surgery
Author(s) -
Maurizio Barbara,
Rita Talamonti,
Anna Teresa Benincasa,
Silvia Tarentini,
Chiara Filippi,
Edoardo Covelli,
Simonetta Monini
Publication year - 2019
Publication title -
audiology and neuro-otology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.106
H-Index - 78
eISSN - 1421-9700
pISSN - 1420-3030
DOI - 10.1159/000502252
Subject(s) - medicine , vestibular evoked myogenic potential , vestibular system , audiology , cochlear implant , semicircular canal , implant , cochlear implantation , surgery
Cochlear implantation (CI) has been reported to negatively affect vestibular function. The study of vestibular function has variably been conducted using different types of diagnostic tools. The combined use of modern, rapidly performing diagnostic tools could prove useful for standardization of the evaluation protocol. Methods: In a group of 28 subjects undergoing CI, the video head impulse test (vHIT), the cervical vestibular evoked myogenic potentials (cVEMP) and the short form of the Dizziness Handicap Inventory (DHI) questionnaire were investigated preoperatively and postoperatively (implant on and off) in both the implanted and the contralateral, nonimplanted ear. All surgeries were performed with a round window approach (RWA), except for 3 otosclerosis cases in which the extended RWA (eRWA) was used. Results: The vHIT of the lateral semicircular canal showed preoperative vestibular involvement in nearly 50% of the cases, while the 3 canals were contemporarily affected in only 14% of the cases. In all the hypofunctional subjects, cVEMP were absent. A low VOR gain in all of the investigated superior semicircular canals was found in 4 subjects (14%). In those subjects (21.7%) in whom cVEMP were preoperatively present and normal on the operated side, the absence of a response was postoperatively recorded. Discussion/Conclusion: The vestibular protocol applied in this study was found to be appropriate for distinguishing between the CI-operated ear and the nonoperated ear. In this regard, cVEMP was found to be more sensitive than vHIT for revealing a vestibular sufferance after CI, though without statistical significance. Finally, the use of RWA surgery apparently did not reduce the occurrence of signs of vestibular impairment.