Influence of cochlear implantation on peripheral vestibular receptor function

Krause, Eike; Louza, Julia; Wechtenbruch, Juliane; Gürkov, Robert

doi:10.1016/j.otohns.2010.01.017

Cited by 73 publications

(66 citation statements)

References 19 publications

(42 reference statements)

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“…commun.]. These results differ significantly from other groups who perform fast insertions without steroid use: these groups describe up to 45% of their patients experiencing vertigo after discharge [Krause et al, 2009[Krause et al, , 2010. None of the patients in our study demonstrated a change of clinical head impulse responses after implantation.…”

Section: Discussioncontrasting

confidence: 81%

“…Another aspect of inner ear trauma related to cochlear implantation is the potential effect on the vestibular system. Various studies report vestibular symptoms occurring in up to 45% of patients after cochlear implantation [Enticott et al, 2006;Krause et al, 2009Krause et al, , 2010. This demonstrates that cochlear implantation causes trauma to both the hearing and vestibular compartments of the inner ear.…”

Section: Introductionmentioning

confidence: 97%

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The Effects of Insertion Speed on Inner Ear Function during Cochlear Implantation: A Comparison Study

2012

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Objective: To investigate the insertion speed and its impact on electrode insertion characteristics, hearing preservation and clinical vestibular function in a prospective cohort study with a retrospective control group at a tertiary otology/neurotology centre. Interventions: Hearing-preserving cochlear implantation using systemic and topical steroids in conjunction with a round-window approach, a complete cochlear coverage electrode and two different electrode insertion speeds [60 mm/min (n = 18) vs. 15 mm/min (n = 22)] was performed. Results: The insertion speed had a significant impact on various insertion characteristics as well as hearing preservation and vestibular function. In conclusion, a slow electrode insertion speed appears to facilitate full electrode insertion, reduce the occurrence of insertion resistance as well as promote preservation of residual hearing and vestibular function after cochlear implantation.

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Section: Discussioncontrasting

confidence: 81%

Section: Introductionmentioning

confidence: 97%

The Effects of Insertion Speed on Inner Ear Function during Cochlear Implantation: A Comparison Study

2012

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“…We prefer the first option as it may limit the risk of hearing loss due to the introduction of a foreign body in the perilymphatic space. This is illustrated by an increasing number of publications reporting deleterious effects of cochlear implantation on the vestibular function [18,19] (approximately 1 mm 2 ) may be a problem in the future. During an acute experiment, the electrode can be precisely maintained in place for a few minutes, manually.…”

Section: Discussionmentioning

confidence: 99%

Eye Movements in Response to Electrical Stimulation of the Lateral and Superior Ampullary Nerves

Guyot¹,

Sigrist²,

Pelizzone³

et al. 2011

Ann Otol Rhinol Laryngol

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Objectives. Recently, we demonstrated that it was possible to elicit vertical eye movements in response to electric stimulation of the posterior ampullary nerve. In order to develop a vestibular implant, a second site of stimulation is required to encode the horizontal movements.Methods. Three patients suffering from a disabling Menière's disease were included in the study. Before a labyrinthectomy via a standard transcanal approach was performed, their lateral and anterior ampullary nerves were surgically exposed under local anesthesia through a procedure we recently developed. The attic was opened, the incus and malleus head removed, and a small well drilled above the horizontal portion of the facial canal to place an electrode. This electrode was used to deliver balanced biphasic trains of electric pulses.Results. Electric stimuli elicited mainly horizontal nystagmus without simultaneous stimulation of the facial nerve. Conclusions.It is possible to stimulate electrically the lateral and superior ampullary nerves without simultaneous stimulation of the facial nerve. As both nerves run close to each other, electric stimulation provoked eye movements that were not purely horizontal but had also some vertical components. Nevertheless, this site can be used to encode horizontal movements because central adaptation may correct unnatural afferent vestibular cues delivered by a prosthetic sensor. The range of stimulus intensities producing a response was broad enough to envision the possibility to encode eye movements of varying speeds.

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“…Cochlear implantation can cause damage both to the semicircular canals [Buchman et al, 2004;Enticott et al, 2006;Filipo et al, 2006;Kluenter et al, 2010;Krause et al, 2009Krause et al, , 2010Migliaccio et al, 2005], and the otolith organs Krause et al, 2010;Melvin et al, 2009]. Comparatively few studies have considered the effect of cochlear implantation on postural stability, which is the outcome variable most important to patients [Buchman et al, 2004;Kluenter et al, 2009Kluenter et al, , 2010.…”

mentioning

confidence: 99%

“…Comparatively few studies have considered the effect of cochlear implantation on postural stability, which is the outcome variable most important to patients [Buchman et al, 2004;Kluenter et al, 2009Kluenter et al, , 2010. Almost all studies have examined balance only long after implantation [Buchman et al, 2004;Kluenter et al, 2009Kluenter et al, , 2010Krause et al, 2010]. Even if there is substantial improvement over time, knowing the risk of short-term symptoms will allow for better preoperative counseling and enhance patient safety following surgery.…”

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confidence: 99%

Short-Term Risk of Falling after Cochlear Implantation

Stevens

Baudhuin

Hullar³

2014

Audiol Neurotol

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Cochlear implantation is a highly effective intervention for hearing loss, but insertion of an implant into the cochlea is often accompanied by loss of residual hearing function. Sometimes, postoperative testing also shows loss of function in the semicircular canals or otolith organs. The effect of this loss on equilibrium, particularly in the short term following surgery, and the risk of falling due to this loss is unknown. We prospectively measured balance in 16 consecutive adult cochlear implant patients before and 2 weeks after surgery. Subjects stood on a foam pad with eyes closed, feet together and arms at the side. The length of time over which this posture could be maintained was recorded up to a maximum value of 30 s indicating normal performance. Ten of 16 subjects reached a maximal time on preoperative testing. Nine of 16 subjects lost balance function after surgery. Four of the 10 subjects with normal preoperative balance function lost function. Subjects older than the age of 60 were more likely to lose balance function than younger subjects. We used previously published values relating balance performance on foam to risk of falling to calculate the fall risk among our subjects. The relative risk of falling increased after surgery by more than threefold in some patients. Imbalance after cochlear implantation may be much more common, particularly in the short term, than previously appreciated. This imbalance is accompanied by an increased risk of falling in many patients. Careful preoperative counseling before implantation and postoperative therapeutic intervention to improve comfort and reduce the chance of falling may be warranted, particularly in patients at a risk for injuries from falls (level of evidence: 2b). i 2014 S. Karger AG, Basel

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Influence of cochlear implantation on peripheral vestibular receptor function

Abstract: Cochlear implantation is a relevant risk factor for damage of peripheral vestibular receptor function. Therefore, preservation not only of residual hearing function but also of vestibular function should be aimed for, by using minimally invasive surgical techniques.

Cited by 73 publications

References 19 publications

The Effects of Insertion Speed on Inner Ear Function during Cochlear Implantation: A Comparison Study

The Effects of Insertion Speed on Inner Ear Function during Cochlear Implantation: A Comparison Study

Eye Movements in Response to Electrical Stimulation of the Lateral and Superior Ampullary Nerves

Short-Term Risk of Falling after Cochlear Implantation

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