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

2021 ◽  
Vol 7 (3) ◽  
pp. 513
Author(s):  
Kiran Natarajan ◽  
Sathiya Murali ◽  
Santhosh Kumar M. ◽  
Manjunatha H. A. ◽  
Adarsh Panicker ◽  
...  
Keyword(s):  
Cochlear Implantation ◽  
Vestibular Function ◽  
Auditory Brainstem ◽  
Cochlear Nerve ◽  
Vestibular Evoked Myogenic Potentials ◽  
Caloric Test ◽  
Cerebellar Flocculus ◽  
Cochlear Nerve Aplasia ◽  
Invasive Techniques ◽  
The Impact

<p><strong>Background:</strong> 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.</p><p><strong>Methods:</strong> 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.</p><p><strong>Results: </strong>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.<strong></strong></p><p><strong>Conclusions: </strong>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.<strong></strong></p>

Objective vestibular function changes in children following cochlear implantation

2021 ◽  
pp. 1-9
Author(s):  
Ruijie Wang ◽  
Xiuhua Chao ◽  
Jianfen Luo ◽  
Daogong Zhang ◽  
Jiliang Xu ◽  
...  
Keyword(s):  
Semicircular Canal ◽  
Cochlear Implantation ◽  
Vestibular Function ◽  
Semicircular Canals ◽  
Vestibular Evoked Myogenic Potentials ◽  
Head Impulse Test ◽  
Caloric Test ◽  
Otolith Organs ◽  
Deterioration Rate ◽  
Vestibular Aqueduct

BACKGROUND: To date, systematically objective evaluations of vestibular function in children with cochlear implantation (CI) have been conducted sparsely, especiallyin children with large vestibular aqueduct syndrome (LVAS). OBJECTIVE: Our goal was to investigate the function of all five vestibular end-organs pre- and post-cochlear implantation in children with LVAS and normal CT. METHODS: In this retrospective cohort study, 34 children (age 4–17 years) with bilateral profound sensorineural hearing loss (SNHL) undergoing unilateral CI were included. Participants included 18 (52.9%) children with LVAS. Objective modalities to evaluate vestibular function included the caloric test, cervical vestibular-evoked myogenic potentials (cVEMP), ocular vestibular-evoked myogenic potentials (oVEMP), and video head impulse test (vHIT). All measurements were performed before surgery and 9 months after surgery. RESULTS: Mean age at CI was 8.1±3.7 years. Caloric testing showed hypofunction in 38.2%of cases before implantation and in 50%after (p >  0.05). We found a significant increase of overall abnormality rate in cVEMP and oVEMP from pre- to post-CI (p <  0.05). In all three semicircular canals tested by vHIT, there were no statistically significant mean gain changes (p >  0.05). Higher deterioration rates in cVEMP (53.3%) and oVEMP (52.0%) after surgery were observed (p <  0.05). In children with LVAS, cVEMP revealed a higher deterioration rate than superior semicircular canal (SSC) and posterior semicircular canal (PSC) (p <  0.05). In children with normal CT, the deterioration rates in VEMPs were both higher than those in vHIT (p <  0.05). CONCLUSIONS: In general, the otolith organs were the most affected peripheral vestibular sensors in children after cochlear implantation. The variations in otolith function influenced by CI were different between children with LVAS and normal CT. We recommend the use of this vestibular function test battery for children with cochlear implantation.

Does Intracochlear Implantation Jeopardize Vestibular Function?

1994 ◽  
Vol 103 (8) ◽  
pp. 609-614 ◽  
Author(s):  
Patrick L. M. Huygen ◽  
Paul Van Den Broek ◽  
Lucas H. M. Mens ◽  
Teun H. Spies ◽  
Ronald J. C. Admiraal
Keyword(s):  
Cochlear Implantation ◽  
Vestibular Function ◽  
Step Test ◽  
Caloric Test ◽  
Vestibular Function Tests ◽  
Function Tests ◽  
Reported Data

We present the results of the vestibular function tests of 35 patients who were selected for cochlear implantation. Vestibular function was evaluated with a caloric test and a velocity step test. The preimplant data were compared to those in previously reported series. Intracochlear implantation was performed in 25 patients. The vestibular complications encountered in this group are presented and discussed. Six patients had normal or residual (but substantial) vestibular function in the ear eligible for implantation. Vestibular function was preserved in 3 patients and was lost in 3 patients, in 1 case through an iatrogenic cause. We estimate the risk of losing vestibular function as a result of intracochlear implantation as between 50% and 60% on the basis of the present and previously reported data.

Cochlear implantation in children with labyrinthine anomalies and cochlear nerve deficiency: Implications for auditory brainstem implantation

2011 ◽  
Vol 121 (9) ◽  
pp. 1979-1988 ◽  
Author(s):  
Craig A. Buchman ◽  
Holly F. B. Teagle ◽  
Patricia A. Roush ◽  
Lisa R. Park ◽  
Debora Hatch ◽  
...  
Keyword(s):  
Cochlear Implantation ◽  
Auditory Brainstem ◽  
Cochlear Nerve ◽  
Cochlear Nerve Deficiency

Auditory Brainstem Implantation in Children with Cochlear Nerve Aplasia/Dysplasia: Preliminary Report of Three Cases

Skull Base ◽  
2007 ◽  
Vol 17 (S 2) ◽  
Author(s):  
Scott Rutherford ◽  
John Thorne ◽  
Andrew King ◽  
Michel Neeff ◽  
Martin O'Driscoll ◽  
...  
Keyword(s):  
Preliminary Report ◽  
Auditory Brainstem ◽  
Cochlear Nerve ◽  
Cochlear Nerve Aplasia

Hearing Restoration with Auditory Brainstem Implant in Three Children with Cochlear Nerve Aplasia

2002 ◽  
Vol 23 (5) ◽  
pp. 682-693 ◽  
Author(s):  
Vittorio Colletti ◽  
Marco Carner ◽  
Francesco Fiorino ◽  
Luca Sacchetto ◽  
Veronica Miorelli ◽  
...  
Keyword(s):  
Auditory Brainstem ◽  
Cochlear Nerve ◽  
Auditory Brainstem Implant ◽  
Cochlear Nerve Aplasia

scholarly journals Vestibular Function After Cochlear Implantation in Partial Deafness Treatment

2021 ◽  
Vol 12 ◽  
Author(s):  
Magdalena Sosna-Duranowska ◽  
Grazyna Tacikowska ◽  
Elzbieta Gos ◽  
Anna Krupa ◽  
Piotr Henryk Skarzynski ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Cochlear Implantation ◽  
Low Frequency ◽  
Vestibular Function ◽  
Hearing Preservation ◽  
Caloric Test ◽  
Profound Hearing Loss ◽  
Single Sided Deafness ◽  
Caloric Response ◽  
Vestibular Damage

Introduction: Cochlear implantation is a fully accepted method of treating individuals with profound hearing loss. Since the indications for cochlear implantation have broadened and include patients with low-frequency residual hearing, single-sided deafness, or an already implanted ear (meaning bilateral cochlear implantation), the emphasis now needs to be on vestibular protection.Materials and Methods: The research group was made up of 107 patients operated on in the otorhinolaryngosurgery department: 59 females and 48 males, aged 10.4–80.2 years (M = 44.4; SD = 18.4) with hearing loss lasting from 1.4 to 56 years (M = 22.7; SD = 13.5). The patients underwent cVEMP, oVEMP, a caloric test, and vHIT assessment preoperatively, and, postoperatively, cVEMP and oVEMP at 1–3 months and a caloric test and vHIT at 4–6 months.Results: After cochlear implantation, there was postoperative loss of cVEMP in 19.2% of the patients, oVEMP in 17.4%, reduction of caloric response in 11.6%, and postoperative destruction of the lateral, anterior, and posterior semicircular canal as measured with vHIT in 7.1, 3.9, and 4% respectively.Conclusions: Hearing preservation techniques in cochlear implantation are connected with vestibular protection, but the risk of vestibular damage in never totally eliminated. The vestibular preservation is associated with hearing preservation and the relation is statistically significant. Informed consent for cochlear implantation must include information about possible vestibular damage. Since the risk of vestibular damage is appreciable, preoperative otoneurological diagnostics need to be conducted in the following situations: qualification for a second implant, after otosurgery (especially if the opposite ear is to be implanted), having a history of vestibular complaints, and when there are no strict audiological or anatomical indications on which side to operate.

scholarly journals Vestibular nerve compression: role of auditory brainstem response and cervical vestibular evoked myogenic potentials

2017 ◽  
Vol 3 (3) ◽  
pp. 749
Author(s):  
Deepa A. Valame ◽  
Geeta B. Gore
Keyword(s):  
Low Frequency ◽  
Auditory Brainstem ◽  
Cochlear Nerve ◽  
Vestibular Evoked Myogenic Potentials ◽  
Anterior Inferior Cerebellar Artery ◽  
Mri Findings ◽  
Study Approach ◽  
Compression Syndrome ◽  
Brainstem Response

<p>The objective of the study was to evaluate the role of ABR and cVEMP in the diagnosis of vestibular compression syndrome (VCS) and to study the association of test results with the MRI findings. This is a case-report of four patients with VCS using case-study approach.<strong><em> </em></strong>Four patients with varying degrees of indentation of vestibulo-cochlear nerve by the anterior inferior cerebellar artery (AICA) loops were studied. Episodic rotatory vertigo was reported by three cases and two cases complained of tinnitus but the characteristic low-frequency ‘type-writer’ type of tinnitus was seen in only one. All cases showed evidence of retrocochlear pathology on ABR although two had normal peripheral hearing status. The cVEMP abnormalities noted were absence of cVEMP and reduced amplitude of cVEMP as compared to instrument-specific age-matched norms; only one case with no indentation of vestibulo-cochlear nerve had normal cVEMP tracings. Presence of AICA loops on the MRI by itself need not necessarily indicate vestibular compression syndrome. However when MRI excludes any other pathology in cases with symptoms such as unilateral sensorineural hearing loss, tinnitus, vertigo; vestibular compression could be the etiology. The likelihood of abnormal test findings is greater when the loop causes indentation of the nerve. </p>

The Effects of Cochlear Implantation on Vestibular Function

2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P60-P60
Author(s):  
Thuy-Anh N. Melvin ◽  
Americo Migliaccio ◽  
John P Carey ◽  
Charles Coleman Della Santina
Keyword(s):  
Cochlear Implantation ◽  
Full Range ◽  
Vestibular Function ◽  
Head Movements ◽  
Vestibular Evoked Myogenic Potentials ◽  
Head Impulse Test ◽  
Head Impulse ◽  
Vestibular Hypofunction ◽  
Before And After ◽  
Vestibulo Ocular Reflex

Objective 1) Measure vestibular function before and after cochlear implantation (CI) using a battery of tests covering the full range of stimulus frequencies over which the normal angular vestibulo-ocular reflex (VOR) stabilizes gaze. Methods Semicircular canal (SCC) function was assayed using head impulse test during 3-dimensional scleral search coil eye movement recordings (HIT), dynamic visual acuity during rapid head movements (DVA), head-shake nystagmus (HSN), and caloric electronystagmography (ENG). Saccular function was determined using vestibular-evoked myogenic potentials (VEMP). Patient self-assessment via the dizziness handicap inventory (DHI) and clinical head impulse testing (cHIT) were also measured. Results One of 28 post-implanted ears (4%) suffered severe loss of vestibular function in all 3 SCCs. HSN revealed no change in 11 subjects. ENG revealed new hypofunction in 1 of 16 ears (6%). Passive DVA revealed no significant change for 16 implanted ears. VEMP revealed significant increase or disappearance in threshold in 5 of 16 ears (31%). DHI scores were variable and correlated poorly with objective tests. The cHIT performed by one otolaryngologist in 14 subjects exhibited 44% sensitivity and 94% specificity for detection of severe hypofunction confirmed via quantitative HIT. Conclusions CI carries a small but nontrivial risk of iatrogenic vestibular hypofunction in the implanted ear. For bilateral simultaneous-CI, the risk of bilateral vestibular hypofunction is ∼0.16%, comparable to the likelihood of meningitis. The cHIT was highly specific for vestibular hypofunction in this study, but likely depends heavily on the examiner's threshold for abnormal.

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