Vestibular dysfunction in cochlear implant candidates: Prevalence and outcomes

Nayak, Neil; Kellermeyer, Brian; Dornton, Lynette; Heyd, Cameron; Kim, Christine S.; Wazen, Jack J.

doi:10.1016/j.amjoto.2021.103171

Cited by 6 publications

(5 citation statements)

References 16 publications

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“…Regarding this data, the authors agree with the literature, where no statistically significant differences have been found in VOR gain before and after implant placement (on and off), as most patients maintained their normal function state 1,2,17 .…”

Section: Gainsupporting

confidence: 89%

Vestibular evaluation with video head impulse test in pediatric cochlear implant patients

Pérez-Castillo,

Ortiz-Rodríguez,

Vélez-Pelcastre

et al. 2024

BMHIM

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Section: Gainsupporting

confidence: 89%

Vestibular evaluation with video head impulse test in pediatric cochlear implant patients

Pérez-Castillo,

Ortiz-Rodríguez,

Vélez-Pelcastre

et al. 2024

BMHIM

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“…Abnormal VOR results are associated with an increased possibility of dizziness lasting longer than 1 month postoperatively. 18 The possibility to use the same CI for the treatment of the undesired possible effects of the CI in vestibular function is attractive. Our findings suggest that the current flow from the cochlear space to the otolith organs was very weak and incapable of effective cross-stimulation from the cochlea to the vestibule.…”

Section: Discussionmentioning

confidence: 99%

“…Vestibular dysfunction is prevalent in CI candidates. Abnormal VOR results are associated with an increased possibility of dizziness lasting longer than 1 month postoperatively 18 . The possibility to use the same CI for the treatment of the undesired possible effects of the CI in vestibular function is attractive.…”

Section: Discussionmentioning

confidence: 99%

Stimulation Crosstalk Between Cochlear And Vestibular Spaces During Cochlear Electrical Stimulation

de Miguel,

Rodriguez Montesdeoca,

Falcón González

et al. 2023

The Laryngoscope

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ObjectivesPossible beneficial “crosstalk” during cochlear implant stimulation on otolith end organs has been hypothesized. The aim of this case–control study is to analyze the effect of electrical cochlear stimulation on the vestibule (otolith end‐organ), when using a cochleo‐vestibular implant, comparing vestibular stimulation (VI) and cochlear stimulation (CI).MethodsFour patients with bilateral vestibulopathy were included. A double electrode array research implant was implanted in all cases. Dynamic Gait Index (DGI), VOR gain measured by using vestibular head impulse test (vHIT), acoustic cervical myogenic responses (cVEMP) recordings, and electrical cVEMP were used in all cases. Trans‐impedance Matrix (TIM) analysis was used to evaluate the current flow from the cochlea to the vestibule.ResultsWhile patients did not have any clinical vestibular improvement with the CI stimulation alone, gait metrics of the patients revealed improvement when the vestibular electrode was stimulated. The average improvement in the DGI was 38% when the vestibular implant was activated, returning to the normal range in all cases. Our findings suggest that any current flow from the cochlear space to the otolith organs was insufficient for effective cross‐stimulation. The functional results correlated with the data obtained in TIM analysis, confirming that there is no current flow from the cochlea to the vestibule.ConclusionThe only way to produce effective electrical otolith end‐organ stimulation, demonstrated with this research implant, is by direct electrical stimulation of the otolith end organs. No effective cross‐stimulation was found from cochlear electrode stimulation.Level of Evidence4 Laryngoscope, 2023

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“…This decision aims to minimize the risk of vestibular disturbances. Additionally, the results of vestibular testing may offer valuable insights for the surgical team, enabling them to consider a specific electrode array design or surgical technique that can mitigate the impact on the vestibular system [ 12 , 13 ]. Another aspect to consider is the estimation of vestibular damage risk [ 14 ].…”

Section: Reviewmentioning

confidence: 99%

Balancing Act: A Comprehensive Review of Vestibular Evaluation in Cochlear Implants

Moreno,

Castillo-Bustamante,

Prieto

2024

Cureus

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Cochlear implantation, a transformative intervention for individuals with profound hearing loss, has evolved significantly over the years. However, its impact on the vestibular system, responsible for balance and spatial orientation, remains a subject of ongoing research and clinical consideration. This narrative review highlights key aspects of vestibular evaluation in patients undergoing cochlear implantation. Preoperative vestibular assessment is crucial to establish baseline vestibular function and identify any pre-existing balance issues. Various tests, including caloric, rotational chair, vestibular-evoked myogenic potential, and video head impulse tests, play a vital role in evaluating vestibular function. The goal is to assess the risk of vestibular disturbances arising from the surgery, guide surgical planning, and detect pre-existing alterations that could be totally or partially compensated. While some patients experience minimal vestibular disruptions, others may encounter transient or persistent balance issues following cochlear implant surgery. Postoperative vestibular testing allows for the early detection of such disturbances, enabling timely interventions like vestibular rehabilitation and evaluating changes produced due to surgical complications or changes in the patient's prior conditions. Challenges in vestibular evaluation include individual variability in patient responses, the proximity of the cochlea to the vestibular system, and the need to tailor testing protocols to individual needs. Further research is essential to refine testing protocols, minimize vestibular disturbances, and improve outcomes for cochlear implant candidates. A multidisciplinary approach involving otolaryngologists, audiologists, and physical therapists is integral to comprehensive patient care in this context. In conclusion, vestibular evaluation in patients undergoing cochlear implantation is critical for optimizing surgical planning, managing postoperative issues, and enhancing the overall quality of life for individuals embarking on the journey of restored hearing.

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Vestibular dysfunction in cochlear implant candidates: Prevalence and outcomes

Cited by 6 publications

References 16 publications

Vestibular evaluation with video head impulse test in pediatric cochlear implant patients

Vestibular evaluation with video head impulse test in pediatric cochlear implant patients

Stimulation Crosstalk Between Cochlear And Vestibular Spaces During Cochlear Electrical Stimulation

Balancing Act: A Comprehensive Review of Vestibular Evaluation in Cochlear Implants

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