Vertigo Associated With Cochlear Implant Surgery: Correlation With Vertigo Diagnostic Result, Electrode Carrier, and Insertion Angle

Objective: Vertigo is a common side effect of cochlear implant (CI) treatment. This prospective study examines the incidence of postoperative vertigo over time and aims to analyze influencing factors such as electrode design and insertion angle (IA).Study Design and Setting: This is a prospective study which has been conducted at a tertiary referral center (academic hospital).Patients: A total of 29 adults were enrolled and received a unilateral CI using one of six different electrode carriers, which were categorized into “structure-preserving” (I), “potentially structure-preserving” (II), and “not structure-preserving” (III).Intervention: Subjective vertigo was assessed by questionnaires at five different time-points before up to 6 months after surgery. The participants were divided into four groups depending on the time of the presence of vertigo before and after surgery. Preoperatively and at 6 months postoperatively, a comprehensive vertigo diagnosis consisting of Romberg test, Unterberger test, subjective visual vertical, optokinetic test, video head impulse test, and caloric irrigation test was performed. In addition, the IA was determined, and the patients were divided in two groups (<430°; ≥430°).Main Outcome Measures: The incidence of vertigo after CI surgery (group 1) was reported, as well as the correlation of subjective vertigo with electrode array categories (I–III) and IA.Results: Among the participants, 45.8% experienced new vertigo after implantation. Based on the questionnaire data, a vestibular origin was suspected in 72.7%. The results did not show a significant correlation with subjective vertigo for any of the performed tests. In group 1 with postoperative vertigo, 18% of patients showed conspicuous results in a quantitative analysis of caloric irrigation test despite the fact that the category I or II electrodes were implanted, which are suitable for structure preservation. Average IA was 404° for the overall group and 409° for group 1. There was no statistically significant correlation between IA and perceived vertigo.Conclusions: Though vertigo after CI surgery seems to be a common complication, the test battery used here could not objectify the symptoms. Further studies should clarify whether this is due to the multifactorial cause of vertigo or to the lack of sensitivity of the tests currently in use. The proof of reduced probability for vertigo when using atraumatic electrode carrier was not successful, nor was the proof of a negative influence of the insertion depth.

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Menstruation Among Adolescent Girls Living in Rural Border Areas

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v4i8.1349 ◽

2020 ◽

Vol 4 (8) ◽

Author(s):

Ritu Gupta ◽

Ravinder K Gupta ◽

Vallabh Dogra ◽

Himani Badyal

Keyword(s):

Abdominal Pain ◽

Menstrual Cycle ◽

Blood Loss ◽

Prospective Study ◽

Adolescent Girls ◽

Common Side Effect ◽

Age Group ◽

Different Types ◽

Study Population ◽

Border Areas

Objective: To study the various beliefs and problems regarding menstruation among adolescent girls living in rural border areas. Design- Prospective study. Setting- Pediatric outpatient clinic. Materials and methods- About 200 adolescent girls (11-19 years) living in rural border areas were enrolled for the study. These girls were asked about menarche, duration of the cycle, amount of blood loss and the various menstrual problems. They were also asked about the various beliefs and myths regarding menstruation. The girls having any illness affecting the menstrual cycle or those suffering from neuropsychiatric disorders were excluded from this study. Results- About 51% of the study population was in the age group 17-18 years. About 43.5% of girls attained menarche at the age of 10-12 years. About 51% of girls did not know about menstruation before menarche. Abdominal pain was the most common side effect seen in 41% of girls during menstruation. About 61% of girls considered themselves unclean during menstruation. Twenty percent avoided schools, 20% avoided kitchen, 12% avoided temples while 10% stayed away from friends/ relatives. Only 33% of girls knew that menstruation stops temporarily after becoming pregnant. Twenty-two percent girls were using sanitary napkins while the rest used different types of clothes during the menstrual cycle. Conclusion- There is a dire need to educate girls regarding menstruation before menarche in the rural border areas. Every mother should discuss in a friendly way regarding various aspects of menstruation.

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The safety of bipolar mode radiofrequency (BMRF) on cochlear implant integrity test; a clinical prospective study

American Journal of Otolaryngology ◽

10.1016/j.amjoto.2020.102584 ◽

2020 ◽

Vol 41 (5) ◽

pp. 102584

Author(s):

Saad Elzayat ◽

Hossam Elsherif ◽

Ihab Nada ◽

Ragaey Youssef

Keyword(s):

Cochlear Implant ◽

Prospective Study ◽

Integrity Test ◽

Bipolar Mode

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When to provide bimodal stimulation in unilateral cochlear implant recepients

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20164815 ◽

2016 ◽

Vol 3 (1) ◽

pp. 128

Author(s):

Poonam Raj ◽

Ruchika Mittal

Keyword(s):

Cochlear Implant ◽

Hearing Aid ◽

Noisy Environment ◽

Implant Surgery ◽

Maximum Benefit ◽

Cochlear Implant Surgery ◽

Group 2 ◽

Achieve Maximum Benefit ◽

Group 1 ◽

Bimodal Hearing

Background: With the steady increase in unilateral cochlear implant surgery as management of bilateral sensorineural hearing loss, the benefits of bimodal hearing have been well documented. However very few studies are available on the timing of bimodal hearing stimulation after cochlear implantation. The present study deals with when to provide bimodal hearing in unilaterally implanted children to achieve maximum benefit. Methods: This study was carried out in 120 children aged between 3-5 years who underwent unilateral cochlear implant surgery. The implant was switched-on two weeks after surgery in all cases. The children were randomized into two groups of 60 each. Group 1 comprised of children who continued to use hearing aid in the non-implanted ear immediately after the cochlear implant surgery. Group 2 children discontinued using hearing aid in the non-implanted ear after surgery and restarted its usage after four weeks of switch on of the cochlear implant. The progress in both groups was monitored using category of auditory performance (CAP) scores and through a questionnaire. Results: The mean age of the children was 3.55 years. 11.6 % of the recipients could localize sounds and 5% could understand speech in noisy environment in Group 2 whereas in 1.7% of the recipients could localize sounds and none of the recipient could understand speech in noisy environment in Group 1 after 3 months of follow up. CAP scores increased steadily in Group 2 over the study period whereas Group 1 recipients did not show the same progress. Conclusions: We recommend that bimodal fitting should be the standard practice for clinical management of children who receive unilateral cochlear implant. The best practice is to restart the use of the hearing aid in the non-implanted ear, after one month of activation of the implant to achieve maximum benefit.

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Impact of Intrascalar Electrode Location, Electrode Type, and Angular Insertion Depth on Residual Hearing in Cochlear Implant Patients

Otology & Neurotology ◽

10.1097/mao.0000000000000829 ◽

2015 ◽

Vol 36 (8) ◽

pp. 1343-1348 ◽

Cited By ~ 56

Author(s):

George B. Wanna ◽

Jack H. Noble ◽

Rene H. Gifford ◽

Mary S. Dietrich ◽

Alex D. Sweeney ◽

...

Keyword(s):

Cochlear Implant ◽

Residual Hearing ◽

Insertion Depth ◽

Electrode Location

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“To Do or Not To Do?” Clinical Integration of Point-Of-Care Ultrasound After Training: A Prospective Study

10.21203/rs.3.rs-104376/v1 ◽

2020 ◽

Author(s):

Wan-Ching Lien ◽

Chih-Heng Chang ◽

Kah-Meng Chong ◽

Meng-Che Wu ◽

Cheng-Yi Wu ◽

...

Keyword(s):

Image Quality ◽

Prospective Study ◽

Patient Care ◽

Point Of Care ◽

Point Of Care Ultrasound ◽

Global Rating ◽

Clinical Integration ◽

Valuable Adjunct ◽

Global Ratings ◽

Group 1

Abstract Background: Point-of-care ultrasound (PoCUS) can serve as a valuable adjunct for patient care. This study aimed to investigate the clinical integration of PoCUS of the first post-graduate year (PGY-1) residents after a PoCUS curriculum.Methods: The prospective study was conducted at the emergency department (ED) of the National Taiwan University Hospital between July 2015 and October 2017. Every PGY-1 resident had one-month ED training and a PoCUS curriculum was implemented during the first week. The post-training objective structured clinical examination global ratings were obtained, as well as the sonographic examinations the residents performed on shifts. Four groups could be identified: group 1 performed PoCUS before and after the curriculum; group 2 performed only after the curriculum; group 3 performed only before the curriculum; the last did not perform any examinations.Results: 239 residents participated. The median global rating was 4 (interquartile ranges, 4-5). After the curriculum, an increasing number of residents integrated PoCUS into patient care (64 vs. 170, p=0.037) with acceptable image quality. No differences existed in the global ratings between 4 groups, however, nearly 30% of residents did not use PoCUS during their shifts. Group 1 performed more cases with better image quality and using ≥2 US applications (8/100 vs. 82/359, p=0.0009), compared with those before the curriculum. Comparing with those in groups 1 and 2, group 1 performed more cases (p<0.0001) with better image quality (p=0.03). “No suitable cases” (25/69), and “choosing other imaging priorities” (43/69) were the main feedbacks in groups 3 and 4.Conclusions: A short focused US training had an immediate positive impact on OSCE global ratings and integration of PoCUS of PGY-1 residents in the ED. The global ratings could not predict whether to use PoCUS in the ED practice. Although the working climate was designated to be friendly for utilizing US, a substantial percentage of residents did not use PoCUS. Further longitudinal studies would be needed for the sustained effects of the curriculum.Trial registration: NCT03738033.

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The addition of a contralateral routing of signals microphone to a unilateral cochlear implant system-A prospective study in speech outcomes

The Laryngoscope ◽

10.1002/lary.23367 ◽

2013 ◽

Vol 123 (3) ◽

pp. 746-751 ◽

Cited By ~ 8

Author(s):

Roochi Arora ◽

Hosam Amoodi ◽

Suzanne Stewart ◽

Lendra Friesen ◽

Vincent Lin ◽

...

Keyword(s):

Cochlear Implant ◽

Prospective Study ◽

System A ◽

A Prospective Study ◽

Implant System

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Evaluating Intracochlear Trauma after Cochlear Implant Electrode Insertion through Middle Fossa Approach in Temporal Bones

Otolaryngology ◽

10.1177/0194599817739837 ◽

2017 ◽

Vol 158 (2) ◽

pp. 350-357 ◽

Cited By ~ 2

Author(s):

Juan Carlos Cisneros Lesser ◽

Rubens de Brito ◽

Graziela de Souza Queiroz Martins ◽

Eloisa Maria Mello Santiago Gebrim ◽

Ricardo Ferreira Bento

Keyword(s):

Cochlear Implant ◽

Round Window ◽

Middle Cranial Fossa ◽

Middle Fossa ◽

Insertion Depth ◽

Middle Fossa Approach ◽

Basal Turn ◽

Fresh Frozen ◽

Electrode Insertion ◽

Temporal Bones

Objective To evaluate cochlear trauma after cochlear implant insertion through a middle fossa approach by means of histologic and imaging studies in temporal bones. Study Design Prospective cadaveric study. Setting University-based temporal bone laboratory. Subjects and Methods Twenty fresh-frozen temporal bones were implanted through a middle cranial fossa basal turn cochleostomy. Ten received a straight electrode and 10 a perimodiolar electrode. Samples were fixed in epoxy resin. Computed tomography (CT) scans determined direction, depth of insertion, and the cochleostomy to round window distance. The samples were polished by a microgrinding technique and microscopically visualized to evaluate intracochlear trauma. Descriptive and analytic statistics were performed to compare both groups. Results The CT scan showed intracochlear insertions in every bone, 10 directed to the middle/apical turn and 10 to the basal turn. In the straight electrode group, the average number of inserted electrodes was 12.3 vs 15.1 for the perimodiolar group ( U = 78, P = .0001). The median insertion depth was larger for the perimodiolar group (14.4 mm vs 12.5 mm, U = 66, P = .021). Only 1 nontraumatic insertion was achieved and 14 samples (70%) had important trauma (Eshraghi grades 3 and 4). No differences were identified comparing position or trauma grades for the 2 electrode models or when comparing trauma depending on the direction of insertion. Conclusion The surgical technique allows a proper intracochlear insertion, but it does not guarantee a correct scala tympani position and carries the risk of important trauma to cochlear microstructures.

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Effectiveness of skull X-RAY to determine cochlear implant insertion depth

Journal of Otolaryngology - Head and Neck Surgery ◽

10.1186/s40463-018-0304-9 ◽

2018 ◽

Vol 47 (1) ◽

Cited By ~ 2

Author(s):

Vinay Fernandes ◽

Yiqiao Wang ◽

Robert Yeung ◽

Sean Symons ◽

Vincent Lin

Keyword(s):

Cochlear Implant ◽

Insertion Depth ◽

X Ray

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Diagnose und Differenzialdiagnose von peripheren und zentralen Schwindelsyndromen

DMW - Deutsche Medizinische Wochenschrift ◽

10.1055/a-0746-4425 ◽

2019 ◽

Vol 144 (12) ◽

pp. 821-829 ◽

Cited By ~ 1

Author(s):

Michael Strupp ◽

Katharina Feil ◽

Andreas Zwergal

Keyword(s):

Laboratory Tests ◽

Time Course ◽

Head Impulse Test ◽

Ocular Motor ◽

Vestibular Disorders ◽

Patient History ◽

Caloric Irrigation ◽

Head Impulse ◽

Accompanying Symptoms ◽

Romberg Test

AbstractThe diagnosis of the various peripheral and central vestibular disorders is mainly based on the patient history (time course, type of symptoms, modulating factors, and accompanying symptoms) and a systematic clinical examination of the vestibular, ocular motor, and cerebellar systems (examination for nystagmus, head impulse test, positional maneuvers, Romberg test and examination for central ocular motor signs). The two most important laboratory tests are the “video-head impulse test” and caloric irrigation. Fortunately, the diagnosis of vestibular disorders has become easier and more precise as a result of the very clinically oriented diagnostic criteria of the Bárány Society (www.jvr-web.org/ICVD.html).

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