The Effects of Cochlear Implantation on Vestibular Function

Melvin, Thuy-Anh N.; Migliaccio, Americo A.; Carey, John P.; Santina, Charles C. Della

doi:10.1016/j.otohns.2008.05.194

Cited by 20 publications

(37 citation statements)

References 32 publications

(49 reference statements)

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“…In fact, electrode insertion gives rise to a vestibular lesion in the saccule and lateral semicircular canal, so it might be reasonable to evaluate the bithermal caloric response and vestibular evoked myogenic potential in subjects with CI. Although the changes of both test responses were similar in a recent report [Katsiari et al, 2013], most studies reported that the lateral semicircular canal function is much less affected by CI than the saccular function [Krause et al, 2010;Meli et al, 2015;Melvin et al, 2009;Robard et al, 2015]. This was supported by a histopathological study which revealed that the saccule was the most frequently damaged vestibular receptor, followed by the utricle and the semicircular canals [Tien and Linthicum, 2002].…”

Section: Discussionmentioning

confidence: 53%

Dexamethasone Is One of the Factors Minimizing the Inner Ear Damage from Electrode Insertion in Cochlear Implantation

et al. 2016

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The aim of this study was to investigate the efficacy of preoperative and intraoperative steroid administration for inner ear protection in cochlear implantation (CI). Nineteen subjects who underwent CI were included in the study, and 10 subjects were enrolled as controls (steroid-administered group, n = 19; control group, n = 10). Dexamethasone (dexamethasone sodium phosphate, 5 mg/ml) was systemically administered preoperatively (1 ml) and topically applied during CI (0.5 ml). The extent of hearing preservation (HP) after CI and the change in the bithermal caloric response were evaluated. Hearing level was calculated using mean thresholds [(250 Hz + 500 Hz + 1,000 Hz + 2,000 Hz)/4]. Preoperative hearing thresholds were similar in the steroid-administered and control groups (100.92 ± 12.60 vs. 103.29 ± 14.39 dB, p = 0.650). The mean thresholds significantly increased in both groups after surgery (108.46 ± 14.08 dB, p = 0.006, for the steroid-administered group; 117.50 ± 6.34 dB, p = 0.027, for the control group), and the difference between the groups was also significant (p = 0.027). The postoperative shift in the hearing thresholds at frequencies of 500 and 1,000 Hz was significant in the steroid-administered group and that at the frequencies of 500, 1,000 and 2,000 Hz was significant in the control group. However, the extent of the shift in hearing threshold levels at each frequency was not significantly different between the groups. Preservation of hearing thresholds was compared between the groups, and there were significantly more subjects with complete and partial HP in the steroid-administered group than in the control group (p = 0.008). The preoperative caloric response was maintained after CI in the steroid-administered group. This study suggests that the perioperative use of a steroid could minimize the inner ear damage after CI.

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Section: Discussionmentioning

confidence: 53%

Dexamethasone Is One of the Factors Minimizing the Inner Ear Damage from Electrode Insertion in Cochlear Implantation

et al. 2016

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“…Some studies have indicated that the sacculus may be particularly susceptible to injury during cochlear implantation Krause et al, 2010;Melvin et al, 2009]. This suggests that specific therapeutic modalities focused on improving responses to linear accelerations might be particularly effective.…”

Section: Mitigation Of Imbalancementioning

confidence: 99%

“…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.…”

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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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“…Recent studies have demonstrated that this finding depends upon examiner experience, and that experienced examiners are, in fact, less likely to declare a positive sign (refixation saccade) than novice examiners [Jorns-Haderli et al, 2007]. However, when detected, the head thrust sign is a highly specific test of whether or not there has been an ablative lesion on the labyrinth [Minor, 1999;Melvin et al, 2009].…”

Section: Avor Gain Reduction Caloric Reduction and Vertigo Controlmentioning

confidence: 99%

Vestibular Function and Vertigo Control after Intratympanic Gentamicin for Ménière’s Disease

Nguyen

Minor²,

Santina

et al. 2009

Audiol Neurotol

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The aim of this study was to correlate long-term vertigo control with reduction in vestibular function after intratympanic (IT) gentamicin therapy for unilateral Ménière’s disease. IT gentamicin injections were given as needed to control vertigo attacks. Vertigo frequency and changes in angular vestibulo-ocular reflex (AVOR) gain (measured using magnetic search coils and manual head thrusts) and caloric weakness were assessed before and after treatment. Better vertigo control after treatment was found with ≥60% reduction in quantitative ipsilateral horizontal semicircular canal AVOR gain from pre-treatment values and/or with caloric unilateral weakness (UW) >50%. However, no correlations were found between the continuous variables of vertigo control and either gain or gain recovery, nor between gain and UW because of the large variability in vertigo control in subjects with lesser reductions in these measures.

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The Effects of Cochlear Implantation on Vestibular Function

Cited by 20 publications

References 32 publications

Dexamethasone Is One of the Factors Minimizing the Inner Ear Damage from Electrode Insertion in Cochlear Implantation

Dexamethasone Is One of the Factors Minimizing the Inner Ear Damage from Electrode Insertion in Cochlear Implantation

Short-Term Risk of Falling after Cochlear Implantation

Vestibular Function and Vertigo Control after Intratympanic Gentamicin for Ménière’s Disease

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