Vestibular evaluation may be performed before CI potentially to reduce the risk of permanent vestibular dysfunction ( 9). It is of utmost importance to identify these patients before implantation, as patients with severe dizziness handicap may be at risk of social isolation, anxiety, and depression and falls and injuries. These severe cases of postimplantation vertigo may in part be explained by preoperative vestibular dysfunction as a result of underlying inner ear pathology, leading to bilateral vestibular areflexia after implantation ( 8). Some CI recipients experience prolonged and severe vertigo affecting daily and social activities and report lower quality of life ( 6, 7). Vertigo or disequilibrium accounts for 25–30% of complications and is usually transient and presents as mild to moderate postoperative dizziness or imbalance ( 1, 3– 5). Vestibular dysfunction is likely the most common complication to CI. However, because of the proximity to the vestibular organs, there is a risk of mechanical damage to the labyrinth, saccule, or the horizontal semicircular canal presumably caused by cochleostomy and insertion of the implant electrode ( 2). Despite vestibular dysfunction, most of the patients report less or unchanged vestibular symptoms.Ĭochlear implantation (CI) is regarded as a safe and minimally invasive procedure due to its low prevalence of severe complications (<2%) ( 1). No significant deterioration or improvement was measured at the last postoperative follow-up thus, vestibular outcomes reached a plateau. vHIT, caloric irrigation, and cVEMP all measured an overall worsening of vestibular function at short-term postoperative follow-up. DHI scores worsened in 6 of 27 patients and improved in 4 of 27 subjects from T0 to T2.Ĭonclusion: This study reports significant deterioration in vestibular function 14 months after cochlear implantation, in a wide range of vestibular tests. DHI total mean scores increased slightly from 10.9 to 12.8 from T0 to T1 and remained at 13.0 at T2 ( p = 0.368). Twenty-nine percent of CI ears showed cVEMP responses at T0, which decreased to 14% ( p = 0.148) at T2. Mean unilateral weakness increased from 19 to 40% from T0 to T2 ( p < 0.005), and the total number of patients with either hypofunctioning or areflexic semicircular canals increased significantly from 7 to 17 ( p < 0.005). Preoperatively, 3 CI ears had correction saccades, which increased to 11 at T2 ( p = 0.017). The mean gain in implanted ears decreased insignificantly from 0.93 to 0.89 ( p = 0.164) from T0 to T2. Results: vHIT testing showed that 3 of 35 ears had abnormal vHIT gain preoperatively, which increased insignificantly to 4 of 35 at the last follow-up ( p = 0.651). Evaluation with a vestibular test battery, involving video head impulse test (vHIT), cervical vestibular evoked myogenic potentials (cVEMP), caloric irrigation test, and dizziness handicap inventory (DHI), were performed at all evaluations. At the CI work-up (T0) and two postoperative follow-ups (T1 and T2), 4 and 14 months following implantation, respectively, all patients had their vestibular function evaluated. Methods: A prospective observational longitudinal cohort study was conducted on 35 CI recipients implanted between 20 last follow-up was conducted in 2021. Objective: This paper aims to evaluate vestibular dysfunction before and after cochlear implantation, the long-term vestibular outcomes, and follows up on previous findings of 35 consecutive adult cochlear implantations evaluated by a battery of vestibular tests. Literature on long-term vestibular outcomes is scarce. Background: Vestibular dysfunction is likely the most common complication to cochlear implantation (CI) and may, in rare cases, result in persistent severe vertigo.
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