Vestibular dysfunction after cochlear implant in adults

Abstract

Using the described techniques and materials, the risk of loss of vestibular function and the incidence of clinical vertigo can be minimized. Postoperative vertigo did not occur more often in patients with preoperative diminished vestibular function than in patients with normal findings. Therefore, preoperative vestibular function tests cannot be an indicator for the frequency of vertigo after CI. If one vestibular organ shows preoperative dysfunction, the non-affected normal vestibular organ should not be implanted.

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

“…Subgroup Analysis. The sub-meta-analyses for both surgical insertion techniques cochleostomy and RW approach showed comparable results investigating nystagmography (cochleostomy: fixed effect model, OR of 0.22; 95% CI 0.09-0.54; P 5 0.0010 9,20,26,27,53,74,[81][82][83][84] and RW approach: random effects model, OR of 0.23; 95% CI 0.07-0.74; P 5 0.0136 15,20,52,75,79,81,85,86 ) and VEMPs (cochleostomy: fixed effect model; OR of 0.08; 95% CI 0.024-0.25; P 5 0.0001 9,12,32,74,78,80 and RW approach: fixed effect model, OR of 0.09; 95% CI 0.02-0.36; P 5 0.0008 8,15,52,75,79 ), compared to the whole meta-analyses with the complete data set. The OR and CI were essentially unaltered compared with the whole meta-analyses.…”

“…Two patients complained about new onset of sway vertigo. Additionally, six studies reported on altered quality of vertigo, [19][20][21]23,28,29 whereas five studies did not observe any change in vertigo quality 17,24,26,27,30 (altered vertigo in 11.6%, 77 of 663 patients). In this subgroup of studies, 19.5% (129 of 663 patients) complained about new onset of vertigo after cochlear implantation.…”

“…1,25 Holinski et al differentiated between sway and rotatory vertigo. 26 Patients with rotatory vertigo increased from two to seven after cochlear implantation. Two patients complained about new onset of sway vertigo.…”

“…Unsteadiness, imbalance, instability, and disequilibrium were summarized in one group and reported by 10 studies. Positional vertigo 1,[17][18][19][20][21][22][23][24] and rotatory/sway vertigo 1,8,19,21,23,[25][26][27][28] were reported in nine studies each. Light-headedness was observed in four studies.…”

“…A total of 16.8% (446 of 2,651) suffered from vertigo after cochlear implantation. 12,16,18,19,[21][22][23]26,30,42,44,46,47, Figure 2 shows the mean age-correlated occurrence of vertigo after cochlear implantation. The majority of patients were children younger than 9 years and adults between 30 to 59 years.…”