Zanetti Diego, Campovecchi Chiara Barbara, Balzanelli Cristiano, Pasini Sara
Otolaryngology Department, University of Brescia, Piazzale Spedali Civili 1, 5100 Brescia, Italy.
Acta Otolaryngol. 2007 May;127(5):452-8. doi: 10.1080/00016480600951442.
We observed 4 cases of paroxysmal positional vertigo (PPV) among 62 cochlear implant (CI) recipients. They occurred in the implanted ear without chronological relation with the surgical procedure or the implant's activation. All of them relapsed within 3 months after an initially successful repositioning maneuver, and finally recovered after the second one. None of the patients showed labyrinthine weakness in the implanted ear. The outbreak of PPV did not affect the patients' speech perception performances.
To report and discuss the occurrence of PPV after cochlear implantation.
Among 32 adult patients who received a Nucleus CI, 4 suffered from PPV on the basis of Dix-Hallpike's maneuvers. After a Semont's repositioning maneuver, recurrences were similarly addressed. An electro-nystagmography (ENG) recording of caloric irrigation tests was obtained once the symptoms subsided.
The observed incidence of 12.5% exceeds the figures reported in the literature. No anatomic abnormalities were identified in these patients, nor were any intraoperative or postoperative complications reported. PPV developed 1-12 months after CI surgery in the posterior canal and relapsed within 3 months. ENG showed a normal reflectivity in two patients, while the other two had a significant prevalence of the implanted side. The outcomes of the speech perception tests after CI in all the four patients matched those of their corresponding categories.
我们在62名接受人工耳蜗植入(CI)的患者中观察到4例阵发性位置性眩晕(PPV)。这些病例均发生在植入耳,与手术过程或植入物启动无时间关联。所有病例在首次成功复位操作后3个月内复发,最终在第二次复位后康复。所有患者植入耳均未出现迷路功能减退。PPV的发作未影响患者的言语感知能力。
报告并讨论人工耳蜗植入术后PPV的发生情况。
在32名接受Nucleus人工耳蜗植入的成年患者中,4例经Dix-Hallpike手法检查诊断为PPV。采用Semont复位手法进行治疗,复发时同样处理。症状缓解后进行了冷热试验的眼震电图(ENG)记录。
观察到的12.5%的发病率高于文献报道的数据。这些患者未发现解剖学异常,也未报告任何术中或术后并发症。PPV在人工耳蜗植入术后1 - 12个月出现在后半规管,并在3个月内复发。ENG检查显示,2例患者反应正常,另外2例植入侧反应明显增强。4例患者人工耳蜗植入后的言语感知测试结果与相应类别相符。