Effects of Unilateral Cochlear Implantation on Balance Control and Sensory Organization in Adult Patients with Profound Hearing Loss

Abstract

Many studies were interested in the consequence of vestibular dysfunction related to cochlear implantation on balance control. This pilot study aimed to assess the effects of unilateral cochlear implantation on the modalities of balance control and sensorimotor strategies. Posturographic and vestibular evaluations were performed in 10 patients (55 ± 20 years) with profound hearing loss who were candidates to undergo unilateral multichannel cochlear implantation. The evaluation was carried out shortly before and one year after surgery. Posturographic tests were also performed in 10 age-matched healthy participants (63 ± 16 years). Vestibular compensation was observed within one year. In addition, postural performances of the patients increased within one year after cochlear implantation, especially in the more complex situations, in which sensory information is either unavailable or conflicting. Before surgery, postural performances were higher in the control group compared to the patients' group. One year after cochlear implantation, postural control was close to normalize. The improvement of postural performance could be explained by a mechanism of vestibular compensation. In addition, the recovery of auditory information which is the consequence of cochlear implantation could lead to an extended exploration of the environment possibly favoring the development of new balance strategies.

Balance Control during Stance and Gait after Cochlear Implant Surgery

“…In contrast, those who would have been considered to be likely to have balance problems (those over 60 years of age and those with a balance deficit preoperatively) had no significant worsening in balance control, possibly because central compensation processes for the prior balance deficit were already active. Previous studies demonstrated a weak improvement in postural stability during stance in some CI patients postoperatively [Buchman et al, 2004;Parietti-Winkler et al, 2015;Shayman et al, 2017] where others have noted no change in the risk of falls based on similar measures to those we used [Louza et al, 2018]. Nonetheless, other authors have pointed out that in some patients a notable worsening took place after CI surgery [Holinski et al, 2012].…”

“…Some authors have suggested that an improvement in stance stability after fitting with a CI is due to improved auditory feedback [Parietti-Winkler et al, 2015;Shayman et al, 2017]. A similar improvement in stability was not observed for gait [Weaver et al, 2017].…”

“…One question that arises is whether the aforementioned weak improvement in stance balance control found by some authors postoperatively [Buchman et al, 2004;Parietti-Winkler et al, 2015;Shayman et al, 2017] is similar for gait balance control. Research to date found no change in gait balance control after CI surgery [Weaver et al, 2017].…”

Meta‐analysis of subjective complaints of vertigo and vestibular tests after cochlear implantation

“…Thirteen studies calculated the unilateral weakness (UW) according to the Jongkees formula . Most studies defined UW > 20% to express hyporeflexia of the hSCC . Two studies referred to the side preponderance, and six studies based the assignment on the slow‐phase velocity, with a range of 3 ° to 20 ° per second as a cutoff value or unilateral weakness (Supporting Fig.…”

Scoping Review of Systems to Train Psychomotor Skills in Hearing Impaired Children

“…Auditory inputs provide additional cues to control balance, creating a hearing “map” of surroundings that NH individuals use to maintain balance control and reduce postural sway [16,22]. HI children may experience balance difficulties, especially those with vestibular deficits [23,24] or within the first year of cochlear implants, when children exhibit higher rates of vestibular loss [25,26,27,28]. Thus, HI children have shown lower stability limits, faster and higher body sway, and higher energy expenditure to keep balance than NH children, indicating a deficit in static and dynamic balance [14,26,29,30].…”