Skip to main content
The Egyptian Journal of Otolaryngology
Download PDF
  • Original article
  • Open access
  • Published:

Vestibular function assessment in cochlear implant patients

The Egyptian Journal of Otolaryngology volume 35, pages 63–70 (2019)Cite this article

Abstract

Background

Anatomical and embryological relations between cochlear and vestibular end organs predispose them to same noxious or developmental factors, thus these may affect either or both systems. Cochlear implantation being a widely used procedure for restoration of hearing in patients who are not candidates for regular amplification, may affect by different means the vestibular system. One of these factors include the surgical procedure. The aim of this study is to assess the vestibular function in cochlear implant candidates before surgery to exclude coexisting vestibular affection with the sensorineural hearing loss (SNHL). Reassessment after operation was done to determine the risk posed by surgery and for correlating the surgical approach to vestibular findings.

Materials and methods

The case series presented herein is of cochlear implant candidates who underwent full audiological and radiological assessment. Vestibular assessment was done before and after operation and included cervical vestibular evoked myogenic potential (cVEMP) and ocular vemp (oVEMP) for evaluation of otolith organs. Video head impulse test (VHIT) was used to evaluate semicircular canal.

Results

Preliminary results show that patients may exhibit vestibular loss concomitant to the SNHL even with the absence of vestibular complaints. Patients who had normal preoperative vestibular function showed affected vestibular tests after the surgery. There was a mismatch between these objective findings and the subjective complaint of imbalance or vertigo.

Conclusion

Despite the minor risk posed by cochlear implant (CI) surgery for the subjective vestibular affection, the side with worse vestibular function should be chosen for CI if other factors are equal to avoid postoperative vestibular loss.

References

  1. Said EA. Vestibular assessment in children with sensorineural hearing loss using both electronystagmography and vestibular-evoked myogenic potential. Egypt J Otolaryngol 2014; 30:43–52.

    Article  Google Scholar 

  2. Santos TGT, Venosa AR, Sampaio ALL. Association between hearing loss and vestibular disorders: a review of the interference of hearing in the balance. Int J Otolaryngol Head Neck Surg 2015; 4:173–179.

    Article  Google Scholar 

  3. Maes L, De Kegel A, van Waelvelde H, Dhooge I. Association between vestibular function and motor performance in hearing-impaired children. Otol Neurotol 2014; 35:343–347.

    Article  Google Scholar 

  4. Arnvig J. Vestibular function in deafness and severe hardness of hearing. Acta Otolaryngol 1955; 4:283–286.

    Article  Google Scholar 

  5. Beck DL, Petrak M, Madell JR, Cushing SL. Update 2015: pediatric vestibular, balance, and hearing disorders. Hear Rev 2015; 22:14.

    Google Scholar 

  6. Gheysen F, Loots G, van Waelvelde H. Motor development of deaf children with and without cochlear Implants. J Deaf Stud Deaf Educ 2008;13:215–224.

    Article  Google Scholar 

  7. Buchman CA, Joy J, Hodges A, Telischi FF, Balkany TJ. Vestibular effects of cochlear implantation. Laryngoscope 2004; 114:1–22.

    Article  Google Scholar 

  8. Todt I, Basta D, Ernst A. Does the surgical approach in cochlear implantation influence the occurrence of postoperative vertigo? Otolaryngol Head Neck Surg 2008; 138:8–12.

    Article  Google Scholar 

  9. Ramsden R. Cochlear implant surgery. In Cochlear implants a practical guide. Cooper HR. Craddock LC. 2006. 216–242.

  10. Tien HC, Linthicum FH. Histopathologic changes in the vestibule after cochlear implantation. Otolaryngol Head Neck Surg 2002; 127:260–264.

    Article  Google Scholar 

  11. Black FO, Lilly DJ, Peterka RJ, Fowler LP, Simmons FB. Vestibulo-ocular and vestibulospinal function before and after cochlear implant surgery. Ann Otol Rhinol Laryngol 1987; 96:106–108.

    Article  CAS  Google Scholar 

  12. Ito J. Influence of the multichannel cochlear implant on vestibular function. Otolaryngol Head Neck Surg 1998; 118:900–906.

    Article  CAS  Google Scholar 

  13. Cohen N, Hoffman RA, Stroschein M. Medical or surgical complications related to the nucleus multichannel cochlear implant. Ann Otol Rhinol Laryngol 1988; 97:8–13.

    Article  Google Scholar 

  14. Kubo T, Yamamoto K, Iwaki T, Doi K, Tamura M. Different forms of dizziness occurring after cochlear implant. Eur Arch Otorhinolaryngol 2001; 258:9–12.

    Article  CAS  Google Scholar 

  15. Handzel O, Burgess BJ, Nadol JB. Histopathology of the peripheral vestibular system after cochlear implantation in the human. Otol Neurotol 2006; 27:57–64.

    Article  Google Scholar 

  16. Melvin TN, Santina CD, Carey JP, Migliaccio AA. The effects of cochlear implantation on vestibular function. Otol Neurotol 2009; 30:87–94.

    Article  Google Scholar 

  17. Krause E, Wechtenbruch J, Rader T, Gürkov R. Influence of cochlear implantation on sacculus function. Otolaryngol Head Neck Surg 2009; 140:108–113.

    Article  Google Scholar 

  18. Licameli G, Zhou G, Kenna MA. Disturbance of vestibular function attributable to cochlear implantation in children. Laryngoscope 2009; 119:740–745.

    Article  Google Scholar 

  19. Jin Y, Nakamura M, Shinjo Y, Kaga K. Vestibular-evoked myogenic potentials in cochlear implant children. Acta Otolaryngol 2006; 126:164–169.

    Article  Google Scholar 

  20. Robard L, Hitier M, Lebas C, Moreau S. Vestibular function and cochlear implant. Eur Arch Otorhinolaryngol 2015; 272: 523.

    Article  Google Scholar 

  21. Migliaccio AA, Santina CD, Carey JP, Niparko JK. The vestibulo-ocular reflex response to head impulses rarely decreases after cochlear implantation. Otol Neurotol 2005; 26:655–660.

    Article  Google Scholar 

  22. Jutila T, Aalto H, Hirvonen TP. Cochlear implantation rarely alters horizontal vestibulo-ocular reflex in motorized head impulse test. Otol Neurotol 2013; 34:48–52.

    Article  Google Scholar 

  23. Krause E, Louza JPR, Wechtenbruch J, Gürkov R. Influence of cochlear implantation on peripheral vestibular receptor function. Otolaryngol Head Neck Surg 2010; 142:809–813.

    Article  Google Scholar 

  24. Enticott JC, Tari S, Koh SM, Dowell RC, O’Leary SJ. Cochlear implant and vestibular function. Otol Neurotol 2006; 27:824–830.

    Article  Google Scholar 

  25. Filipo R, Patrizi M, La Gamma R, D’Elia C, La Rosa G, Barbara M. Vestibular impairment and cochlear implantation. Acta Otolaryngol 2006; 126:1266–1274.

    Article  Google Scholar 

  26. Batuecas-Caletrio A, Klumpp M, Santacruz-Ruiz S, Benito Gonzalez F, Gonzalez Sánchez E, Arriaga M. Vestibular function in cochlear implantation: correlating objectiveness and subjectiveness. Laryngoscope 2015; 125:2371–2375.

    Article  Google Scholar 

  27. Basta D, Todt I, Goepel F, Ernst A. Loss of saccular function after cochlear implantation: the diagnostic impact of intracochlear electrically elicited vestibular evoked myogenic potentials. Audiol Neurootol 2008; 13:187–192.

    Article  CAS  Google Scholar 

  28. MacDougall GH, Curthoys IS. Plasticity during vestibular compensation: the role of saccades. Front Neurol 2012; 3:21.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Otolaryngology, Alexandria University School of Medicine, Alexandria University Hospitals, Alexandria, Egypt

    Alia A. R. M. El-Karaksy MSc Master Degree (Audiovestibular Medicine), Hesham S. Kouzo & Mohamed A. Talaat

  2. Alexandria University, Egypt

    Mohamed B. Attallah (Professor of otolarygology)

Authors
  1. Alia A. R. M. El-Karaksy MSc Master Degree
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Hesham S. Kouzo
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Mohamed B. Attallah
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Mohamed A. Talaat
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Alia A. R. M. El-Karaksy MSc Master Degree.

Additional information

This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.

Rights and permissions

This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

El-Karaksy, A.A.R.M., Kouzo, H.S., Attallah, M.B. et al. Vestibular function assessment in cochlear implant patients. Egypt J Otolaryngol 35, 63–70 (2019). https://doi.org/10.4103/ejo.ejo_55_18

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.4103/ejo.ejo_55_18

Keywords