Postural disorders induced by cochlear implantation in normo-reflexic patients: A potential origin of a transient geocentric perception disorder

Fabre-Adinolfi, Dimitri; Ceyte, Hadrien; Hoffmann, Charles; Frère, Julien; Parietti‐Winkler, Cécile

doi:10.1016/j.gaitpost.2020.08.106

Cited by 2 publications

(1 citation statement)

References 22 publications

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“…We also showed that SVV angle significantly deviated away from the operated ear at 1 day and 1 week, before returning to preoperative levels by 1 month. This finding is consistent with other studies showing similar results after cochlear implantation (19,28,29). However, the patient’s experiences of dizziness were not associated with a significantly different deviation in SVV angle.…”

Section: Discussionsupporting

confidence: 94%

Four-Point Impedance and Utricular Dysfunction Is Associated with Postoperative Dizziness after Cochlear Implantation

et al. 2023

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Introduction Postimplantation dizziness is common, affecting approximately 50% of patients. Theories for dizziness include utricular inflammation, endolymphatic hydrops, and loss of perilymph. Four-point impedance (4PI) is a novel impedance measurement in cochlear implantation that shows potential to predict hearing loss, inflammation, and fibrotic tissue response. Here, we associate 4PI with dizziness after implantation and explore the link with utricular function. Methods Subjective visual vertical (SVV) as a measure of utricular function was recorded preoperatively as a baseline. 4PI was measured immediately postinsertion. Ongoing follow-up was performed at 1 day, 1 week, and 1 month, postoperatively. At each follow-up, 4PI, SVV, and the patients’ subjective experience of dizziness were assessed. Discussion Thirty-eight adults were recruited. One-day 4PI was significantly higher in patients dizzy within the next week (254 Ω vs 171 Ω, p = 0.015). The optimum threshold on receiver operating characteristic curve was 190 Ω, above which patients had 10 times greater odds of developing dizziness (Fisher exact test, OR = 9.95, p = 0.0092). This suggests that 4PI varies with changes in the intracochlear environment resulting in dizziness, such as inflammation or hydrops. SVV significantly deviated away from the operated ear at 1 day (fixed effect estimate = 2.6°, p ≤ 0.0001) and 1 week (fixed effect estimate 2.7°, p ≤ 0.001). Conclusion One-day 4PI is a potentially useful marker for detecting postoperative dizziness after cochlear implantation. Of the current theories for postoperative dizziness, inflammation might explain the findings seen here, as would changes in hydrostatic pressure. Future research should focus on detecting and exploring these labyrinthine changes in further detail.

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Section: Discussionsupporting

confidence: 94%

Four-Point Impedance and Utricular Dysfunction Is Associated with Postoperative Dizziness after Cochlear Implantation

et al. 2023

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Cochlear implant surgery and perioperative dizziness is associated with utricular hyperfunction

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Orimoto

et al. 2022

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BACKGROUND: Dizziness is a common perioperative complication after cochlear implantation (CI). To date, the exact cause behind this phenomenon remains unclear. There is recent evidence to suggest that otolith function, specifically utricular, may be affected shortly after CI surgery, however whether these changes are related to patient symptoms has not yet been investigated. OBJECTIVE: To determine whether CI surgery and perioperative dizziness is associated with changes on utricular function. METHODS: We performed an observational study on patients undergoing routine CI surgery. Utricular function was assessed using the Subjective Visual Vertical (SVV), and perioperative dizziness was determined using a questionnaire. The study followed patients before surgery and then again 1-day, 1-week and 6-weeks after implantation. RESULTS: Forty-one adult CI recipients participated in the study. The SVV deviated away from the operated ear by an average of 2.17° a day after implantation, 0.889° 1 week and –0.25° 6 weeks after surgery. Dizziness contributed to a tilt of 0.5° away from the implanted ear. These deviations were statistically significant. CONCLUSIONS: CI surgery causes utricular hyperfunction in the operated ear that resolves over 6 weeks. SVV tilts were greater in participants experiencing dizziness, suggesting that utricular hyperfunction may contribute to the dizziness.

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Postural disorders induced by cochlear implantation in normo-reflexic patients: A potential origin of a transient geocentric perception disorder

Cited by 2 publications

References 22 publications

Four-Point Impedance and Utricular Dysfunction Is Associated with Postoperative Dizziness after Cochlear Implantation

Four-Point Impedance and Utricular Dysfunction Is Associated with Postoperative Dizziness after Cochlear Implantation

Cochlear implant surgery and perioperative dizziness is associated with utricular hyperfunction

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