ORIGINAL ARTICLE
VESTIBULAR SYMPTOMS AFTER COCHLEAR IMPLANTATION: CLINICAL OVERVIEW AFTER A 2-YEAR FOLLOW-UP
,
 
Elżbieta Gos 2, C-D
,
 
,
 
 
 
More details
Hide details
1
Department of Otoneurology, Institute of Physiology and Pathology of Hearing, Poland
 
2
Department of Teleaudiology and Screening, Institute of Physiology and Pathology of Hearing, Poland
 
3
Department of Teleaudiology and Screening, Institute of Physiology and Pathology of Hearing,, Poland
 
4
Institute of Sensory Organs, Poland
 
5
Heart Failure and Cardiac Rehabilitation Department, Second Faculty of the Medical University of Warsaw,, Poland
 
6
Otorhinolaryngosurgery Clinic, Institute of Physiology and Pathology of Hearing, Warsaw, Poland, Poland
 
 
A - Research concept and design; B - Collection and/or assembly of data; C - Data analysis and interpretation; D - Writing the article; E - Critical revision of the article; F - Final approval of article;
 
 
Submission date: 2020-07-08
 
 
Final revision date: 2020-11-09
 
 
Acceptance date: 2020-11-10
 
 
Publication date: 2020-12-31
 
 
Corresponding author
Magdalena Sosna-Duranowska   

Department of Otoneurology, Institute of Physiology and Pathology of Hearing, Mokra 17, 05830, Nadarzyn, Poland
 
 
J Hear Sci 2020;10(4):20-26
 
KEYWORDS
TOPICS
ABSTRACT
Background:
Vestibular symptoms and balance disorders are still common complaints reported by the patients after cochlear implantation (CI). Much research has been devoted to assess dizzy patients after cochlear implantation using both self-prepared questionnaires as well as validated life-quality scales. From this work, various approaches to classifying symptoms according to their onset and duration have been recommended.

Material and methods:
We studied 101 patients after round window approach (RWA) cochlear implantation giving them a self-prepared questionnaire asking them to list their major vestibular complaints formulated according to the consensus document of the Barany Society Committee for the classification of vestibular disorders. Those with persistent symptoms (both postoperatively and existing preoperatively) also filled in a DHI questionnaire. Additionally, cVEMP, oVEMP, caloric, and vHIT tests were performed before and after the CI procedure.

Results:
The 101 patients were divided into four groups: with early symptoms (n = 25), with late symptoms (n = 2), with preoperative symptoms (n = 13), and with no symptoms (n = 61). Among the patients with early symptoms, 15 reported spontaneous vertigo attack, 6 only unsteadiness and/or lateropulsion, and 4 had other symptoms such as orthostatic vertigo, positional vertigo, visual tilt, and head-motion vertigo.

Conclusions:
Close to 40% of the CI recipients suffered from vestibular complaints, either in the postoperative period or from already existing preoperative symptoms. The vast majority of postoperative complaints were transient and only rare cases (with preexisting inner ear pathologies and/or comorbidities) evolved into persistent dysfunction.

 
REFERENCES (29)
1.
Fina M, Skinner M, Goebel JA, et al. Vestibular dysfunction after cochlear implantation. Otol Neurotol, 2003; 24:234–242.
 
2.
Buchman CA, Joy J, Hodges A, et al. Vestibular effects of cochlear implantation. Laryngoscope, 2004; 114: 1–22.
 
3.
Kubo T, Yamamoto K, Iwaki T, et al. Different forms of dizziness occurring after cochlear implant. Eur Arch Otorhinolaryngol, 2001; 258: 9–12.
 
4.
Mangham CA. Effect of cochlear prostheses on vestibuloocular reflexes to rotation. Ann Otol Rhinol Laryngol Suppl, 1987; 12: 101–4.
 
5.
O’Leary MJ, Fayad J, House WF, Linthicum FH. Electrode insertion trauma in cochlear implantation. Ann Otol Rhinol Laryngol, 1991; 100: 695–9.
 
6.
Tien H-C, Linthicum FH. Histopathologic changes in the vestibule after cochlear implantation. Otolaryngol Head Neck Surg, 2002; 127:260–64.
 
7.
Eshragi AA, Lang DM, Roell J, Van de Water TR, Garnham C, Rodrigues H, Guardiola M, Gupta C, Mittal J. Mechanisms of programmed cell death signaling in hair cells and support cells post-electrode insertion trauma. Acta Otolaryngol, 2015; 135, 328–34.
 
8.
Viccaro M, Mancini P, La Gamma R et al. Positional vertigo and cochlear implantation. Otol Neurotol, 2007; 28: 764–7.
 
9.
Coordes A, Basta D, Götze R et al. Sound-induced vertigo after cochlear implantation. Otol Neurotol, 2012; 33: 335–42.
 
10.
Batuecas-Caletrio A, Klumpp M, Santacruz-Ruiz S, Benito Gonzalez F, Gonzalez Sánchez E, Arriaga M. Vestibular function in cochlear implantation: correlating objectiveness and subjectiveness. Laryngoscope, 2015 Oct; 125(10): 2371–5.
 
11.
Imai T, Ito M, Takeda N, Uno A, Matsunaga T, Sekine K, Kubo T. Natural course of the remission of vertigo in patients with benign paroxysmal positional vertigo. Neurology, 2005; 64(50): 920–1.
 
12.
Ito J. Influence of the multichannel cochlear implant on vestibular function. Otolaryngol Head Neck Surg, 1998; 118(6): 900–2.
 
13.
Zawawi F, Alobaid F, Leroux T, Zeitouni AG. Patients reported outcome post-cochlear implantation: how severe is their dizziness? J Otolaryngol Head Neck Surg, 2014; 43: 49.
 
14.
Bisdorff A, Von Brevern M, Lempert T, Newman-Toker DE. Classification of vestibular symptoms: towards an international classification of vestibular disorders. J Vestib Res, 2009; 19: 1–13.
 
15.
Gos E, Ratajczak A, Tacikowska G, Sosna M, Piłka A, Skarżyński PH. Kwestionariusz przesiewowy do oceny zawrotów głowy i zaburzeń równowagi. Nowa Audiofonologia, 2019; 8(2): 37–42.
 
16.
Szostek-Rogula S, Zamysłowska-Szmytke E. Walidacja polskiej wersji kwestionariusza Dizziness Handicap Inventory. Otorynolaryngologia, 2018; 17(3): 105–11.
 
17.
Skarzynski H, Lorens A, Piotrowska A, Skarzynski PH. Hearing preservation in partial deafness treatment. Med Sci Monit, 2010; 16: 555–62.
 
18.
Skarzynski H, Lorens A, Piotrowska A, Anderson I. Preservation of low frequency hearing in partial deafness CI (PDCI) using the round window surgical approach. Acta Otolaryngol (Stockh), 2007; 127: 41–8.
 
19.
Krause E, Louza JPR, Wechtenbruch J, Hempel J-M, Rader T, Gürkov R. Incidence and quality of vertigo symptoms after cochlear implantation. J Laryngol Otol, 2009; 123(3): 278–82.
 
20.
Todt I, Basta D, Ernst A. Does the surgical approach in cochlear implantation influence the occurrence of postoperative vertigo? Otolaryngol Neck Surg, 2008; 138(1): 8–12.
 
21.
Sosna M, Tacikowska G, Pietrasik K, Skarzynski H, Skarzynski PH. Vestibular status in partial deafness. Braz J Otorhinolaryngol, 2019 Nov 20; doi: 10.1016/j.bjorl.2019.09.012.
 
22.
Meli A, Musameci Aud B, Tognocchi Aud S, Gaggi Aud R, Cristofari E. Vestibular function after cochlear implant surgery. Cochlear Implants Intl, 2016 May; 17(3): 151–7.
 
23.
Melvin T-A, Della Santina C, Carey J, Migliaccio A. The effects of cochlear implantation on vestibular function. Otol Neurotol, 2009 Jan; 30(1): 87–94.
 
24.
McCall A, Yates B. Compensation following bilateral vestibular damage. Front Neurol, 2011 Dec; 2: 88.
 
25.
Gillespie MB, Minor LB. Prognosis in bilateral vestibular hypofunction. Laryngoscope, 1999; 109: 35-41.
 
26.
Della Santina CC, Migliaccio AA, Hayden R et al. Current and future management of bilateral loss of vestibular sensation: an update of John Hopkins Multichannel Prosthesis Project. Cochlear Implants Intl, 2010 Sep; 11(Suppl 2): 2–11.
 
27.
Rubinstein JT, Bierer S, Kaneko C, Ling L, Nie K, Oxford T et al. Implantation of the semicircular canals with preservation of hearing and rotational sensitivity: a vestibular neurostimulator suitable for clinical research. Otol Neurotol, 2012 Jul; 33(5): 789–96.
 
28.
Perez Fornos A, Cavuscens S, Ranieri M, van de Berg R, Stokroos R, Kingma H, Guyot JP, Guinand N. The vestibular implant: a probe in orbit around the human balance system. J Vestib Res, 2017; 27(1): 51–61.
 
29.
Whitney SL, Sparto PJ, Furman JM. Vestibular rehabilitation and factors that can affect outcome. Semin Neurol, 2020 Feb; 40(1): 165–72.
 
Journals System - logo
Scroll to top