Long-term follow-up of late onset vestibular complaints in patients with cochlear implant

Abstract

The total population was 72% male and 28% female, median age was 58 years; minimal follow-up was 9 months (mean = 51, median = 34). Cochleostomy was performed in eight cases and round window insertion was performed in 19 (two patients were removed from each group in the analysis due to their bilateral implantation under a different approach). The mean time from implant to vestibular symptoms was 53 months, median = 32; a Kaplan Meier graphic showed the round window approach has faster onset of symptoms with statistical significance (p = 0.020). The most common complaint was instability in all patients and after both surgical approaches. No difference in symptoms was found with a Kruskall Wallis test except for vertigo spells (more common in the round window approach). In 12 patients the symptomatology was attributed to the implanted side. In the long-term follow-up a relatively high number of patients (20/25) recovered with standard treatment, suggesting the presence of the implant is not associated with poor recovery prognosis.

Meta‐analysis of subjective complaints of vertigo and vestibular tests after cochlear implantation

“…Light‐headedness was observed in four studies. Kubo et al and Gonzalez‐Navarro et al reported “auditory fluctuation,” “vagal symptoms,” and “aural fullness” postoperatively . Holinski et al differentiated between sway and rotatory vertigo .…”

“…In the literature, the presentation of vertigo is widely variable. Some authors differentiate subtypes of vertigo or even severity, whereas others only publish data either on “mild imbalance” or “severe dizziness.” Some patients experience transient vertigo . Kubo et al proposed the subdivision of postoperative vertigo into three groups: early dizziness, a continuous type of dizziness, and delayed vertigo with predominant dizziness qualities for each type .…”

Long-term vestibular evoked myogenic potential responses in children with cochlear implant

“…[25] González-Navarro ve ark. [2] birinci aydan sonra ortaya çıkan geç dönem vertigoyu değerlendirmişler ve 25 hastanın 20'sinde semptomların standart vestibüler rehabilitasyon ile düzeldiğini ifade etmişlerdir. Çocuklarda gelişen akut vestibüler hasar erişkinlere kıyasla çok daha kısa sürede kompanze olabildiğinden çocuk koklear implant hastalarında çoğu zaman vestibüler etkilenim atlanabilir.…”

“…Çocuk hastalarda yapılan ilk çalışmaya ait olan bildirimde vestibüler etkilenim %40 civarındadır. [1,2] Literatürde koklear implant uygulanan hastalarda vestibüler sistemi değerlendiren çalışma sayısı kısıtlıdır. Sakkül kokleaya en yakın vestibüler algılayıcıdır.…”

Vestibulo-Cochlear Function After Cochlear Implantation in Patients With Meniere’s Disease

“…The prevalence of vestibular end organ functions in SNHL and estimates of vestibular dysfunction preoperatively range from 20% to 70% [5] . After CI in SNHL, late onset vestibular complaints range from 4.16% [6] to 45.4% [7] . To date, few studies have evaluated the vestibular symptoms after CI surgery as well as the presence of an added lesion to the vestibule [5] .…”