Severe Vertigo After Cochlear Implantation: Acute Pneumolabyrinth

Karataş, Erkan; Toplu, Yüksel; Gündüz, Emrah; Demir, İsmail

doi:10.4274/balkanmedj.2017.1088

Cited by 7 publications

(11 citation statements)

References 4 publications

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“…Acute pneumolabyrinth causing severe vertigo after cochlear implantation in the early post-operative period has been reported after excessively drilling the promontory cochleostomy with possible basilar membrane damage. 12 Histological changes such as soft tissue changes might result in impaired vestibular function. 5 Kubo et al reported that in most CI patients vertigo resolved within one month.…”

Section: Discussionmentioning

confidence: 99%

Vestibular dysfunction after cochlear and auditory brainstem implantation: Madras ENT Research Foundation experience

Natarajan¹,

Murali²,

Kumar³

et al. 2021

Int J Otorhinolaryngol Head Neck Surg

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Background: Cochlear implantation is an established procedure for patients with bilateral severe to profound sensorineural hearing loss. CI may, in some implantees, have a detrimental impact on vestibular function. Auditory brainstem implantation is a safe and effective procedure in children with bilateral cochlear and cochlear nerve aplasia. The aim of the study was to assess the impact of cochlear implantation and auditory brainstem implantation on the vestibular function.Methods: Three hundred and twenty patients who underwent CI surgery over a four years period from November 2016 to November 2020 were studied for symptoms of vestibular disturbance. Twenty three patients complained of giddiness and underwent vestibular function testing including videooculography, caloric test and vestibular evoked myogenic potentials. 48 patients with cochlear and cochlear nerve aplasia underwent ABI surgery from September 2009 to March 2019. The correlation between the size of the flocculus and the presence of vestibular symptoms was studied.Results: After CI, vestibular disturbances were seen in 23 patients (7.2%) and were transient. In auditory brainstem implantees, vestibular disturbances were seen in eight patients (16.7%) and were found to correlate with the size of the cerebellar flocculus.Conclusions: Vestibular disturbances are rare after cochlear and auditory brainstem implant surgery. During CI, the preservation of vestibular function should be attempted using minimally invasive techniques. ABI surgery requires meticulous dissection, especially of a large cerebellar flocculus to minimize the possibility of vestibular disturbances.

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Section: Discussionmentioning

confidence: 99%

Vestibular dysfunction after cochlear and auditory brainstem implantation: Madras ENT Research Foundation experience

Natarajan¹,

Murali²,

Kumar³

et al. 2021

Int J Otorhinolaryngol Head Neck Surg

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“…The low perilymphatic pressure, explained by the patient using a shunt to manage hydrocephalus, makes it easier for the air to enter the cochlea. It is possible, but not very likely, that the external CI magnet could have altered the shunt settings [6,7]. Careful testing was done prior to implantation, with external CI magnets as well as a VP shunt (Codman Hakim valve) of the same type as the patient was implanted with.…”

Section: Discussionmentioning

confidence: 99%

“…One possible solution to prevent air from entering the cochlea that was discussed was to do a revision surgery to better seal around the implant where it enters the cochlea through the round window [5]. Other cases of pneumolabyrinth after CI described in the literature were treated conservatively or with revision surgery [2,4,7]. In our case we choose to adjust the shunt settings to speed up the recovery process and avoid another surgery.…”

Section: Discussionmentioning

confidence: 99%

Pneumolabyrinth following cochlear implantation resolved after shunt adjustment

Hallin

Stillesjö

Sundblom

et al. 2020

Acta Oto-Laryngologica Case Reports

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We present a case of a male with a history of repeated surgeries for a cerebellar astrocytoma, leading to profound deafness and facial paresis on the left side. A ventriculoperitoneal (VP) shunt was inserted to manage hydrocephalus. At the age of 46 the hearing suddenly disappeared on the right side, where he received a cochlear implant (CI). At implant activation, impedances showed atypical high values. One month later impedance levels had further increased and the patient had no benefit from the CI. A computed tomography (CT) scan suggested air in the cochlea (pneumolabyrinth). The shunt was adjusted to elevate the cerebrospinal fluid (CSF) pressure and the pressure in the perilymph to prevent air from entering the cochlea via the round window. One year after activation the electrode impedances were normal and the hearing outcome from the implant was successful.

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“…In a series by Choi et al the incidence of pneumolabyrinth was 8% among the trauma cases with temporal bone fracture while in another series by Choi et al it was 1.5% [2,3]. The various causes other than temporal bone fracture causing pneumolabyrinth are rupture of round window due to an impulsive force, perilymphatic fistula, displacement of stapes prosthesis into vestibule, congenital malformations, fracture or dislocation or subluxation of stapes and cochleostomy with cochlear implant within [4][5][6][7][8][9][10]. Stapes footplate luxation out of the oval window or into the vestibule is rare [6][7][8][9].…”

Section: Global Journal Of Otolaryngology Discussionmentioning

confidence: 99%

A Rare Cause of Vertigo- Case Report and Review of Literature

Sabharisan¹

2020

GJO

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A Rare Cause of Vertigo-Case Report and Review of LiteratureCase Report 50 years old male patient presented to Outpatient Department with history of giddiness and ringing sensation in the ear for two months. He also complained of reduced hearing in the right year. On further probing of history, he gave history of trauma to the right ear two and a half months ago while doing field work, where while loading goods a stick had accidentally injured his right ear (stick entered into his external auditory canal). Following the trauma, he had one episode of ear bleed immediately. Weber's test (512Hz) Absolute bone conduction (512Hz) Reduced same as examiner

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Severe Vertigo After Cochlear Implantation: Acute Pneumolabyrinth

Cited by 7 publications

References 4 publications

Vestibular dysfunction after cochlear and auditory brainstem implantation: Madras ENT Research Foundation experience

Vestibular dysfunction after cochlear and auditory brainstem implantation: Madras ENT Research Foundation experience

Pneumolabyrinth following cochlear implantation resolved after shunt adjustment

A Rare Cause of Vertigo- Case Report and Review of Literature

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