Cochlear Implantation Hearing Outcome in Ménière’s Disease

Abstract

Objective The aim of this study was to evaluate the hearing outcome of cochlear implantation in patients deafened by Ménière’s disease. Study Design Retrospective single-institution study. Setting Tertiary medical center. Methods Our institutional database of 1400 patients with cochlear implants was reviewed to identify cases with deafness due to Ménière’s disease. Twenty-nine patients were identified: 24 with unilateral and 5 with sequential bilateral cochlear implants. Pre- and postoperative speech recognition scores and medical data were extracted from the medical record and analyzed. Results Overall the mean difference between pre- and postoperative speech recognition after >1 year was 56% (95% CI, 47.08%-64.92%). The mean preoperative monosyllabic word score was 9.5%, and the mean postoperative scores at 1 month, 3 months, 6 months, 1 year, and >1 year were 37.1%, 46.1%, 54.1%, 59.1%, and 66.8%, respectively. Cochlear implantation resulted in improved word scores in all patients regardless of prior medical or surgical treatment (endolymphatic sac, labyrinthectomy). The mean postoperative hearing improvement in patients aged <70 and ≥70 years was 65.26% (95% CI, 54.79%-75.73%) and 40.00% (95% CI, 27.22%-52.77%). Postoperative word scores in patients with bilateral cochlear implants were not significantly different between the first and second implanted ears or between the monoaural and binaural testing conditions. Conclusion Cochlear implant in patients deafened by Ménière’s disease significantly improves word recognition scores regardless of whether medical or surgical treatment is used prior to implantation. The potential improvement in word recognition scores decreases after age 70 years.

Role of prior intratympanic gentamicin and corticosteroids therapy on speech understanding in patients with Menière's disease after cochlear implantation

“…Another study by Chien et al in 2022 report that among 29 Meniere patients who received CI, an overall statistically significant difference of 56% was found between mean pre- and post-operative speech recognition after 1 year, which is similar to our study [ 5 ]. The study also reports increasing mean post-operative scores at 1 month, 3 months, 6 months, 1 year, and after 1 year at 37.1%, 46.1%, 54.1%, 59.1%, and 66.8% respectively which are similar to our study although a repeated measures ANOVA analysis is missing in this study.…”

Recent surgical advances and continued controversies in medically refractory Meniere's disease

“…Cochlear implantation has an important role in both hearing rehabilitation for single-sided deafness as well as ensuring intact hearing in the event of future contralateral hearing loss. It does not interfere with vertigo control following labyrinthectomy [19,20] and is a popular strategy for hearing rehabilitation in Meniere's disease patients.…”