Control of Disabling Vertigo in Ménière’s Disease Following Cochlear Implantation without Labyrinthectomy

Abstract

Background: The placement of a cochlear implant (CI) can restore auditory function in the case of profound cochlear deafness, which may be due to Ménière’s disease (MD) or be associated with symptoms related to endolymphatic hydrops. The usual treatment of disabling vertigo in MD is based on vestibular deafferentation by labyrinth ablation. The aim of the present study was to retrospectively evaluate the efficacy of the CI in the control of disabling vestibular manifestations in the case of MD unresponsive to medical treatments. Methods: A case series of five MD patients with disabling vestibular manifestations associated with profound hearing loss was included. A complete audio-vestibular evaluation was performed after CI positioning. Results: All patients reported clinical benefits after implant positioning: no vestibular crisis was reported after the surgery. The vHIT and the caloric test showed a normal function or a mild vestibular hypofunction. The auditory performances were comparable to those in the general implanted population. All patients reported subjective tinnitus reduction. Conclusions: To date, very few studies have reported vestibular outcomes in hydropic pathology on the implanted side; our results are encouraging. We can therefore confirm the efficacy and safety of the CI as a unique treatment for hearing loss, dizziness, and tinnitus in case of disabling cochlear hydrops, especially in those patients where the history of the disease requires preservation of the vestibular function.

Endolymphatic Hydrops Magnet Resonance Imaging in Ménière’s Disease Patients after Cochlea Implantation

“…Patients with severe sensorineural hearing loss as a sequel of MD who do not benefit from a hearing aid are often managed with CI [ 29 , 30 ]. The control of vertigo often has a greater and more important impact on the quality of life than the improvement in understanding speech [ 31 ].…”

A Spectrum of Intraoperative and Postoperative Complications of Cochlear Implants: A Critical Review

“…Cochlear implantation and labyrinthectomy together help in gaining the restoration of binaural hearing sensation. There is a potential vertigo elimination along with tinnitus by using ablation processes under general anesthesia [ 21 ]. Labyrinthectomy is not the reason for this reduction; cochlear implantation is because older studies didn't show tinnitus reduction when implant placement is not done, and the labyrinth is removed [ 22 ].…”