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人工耳蜗植入后引发的眩晕

Sound-induced vertigo after cochlear implantation.

机构信息

Department of Otolaryngology at UKB, Hospital of University of Berlin, Charité Medical School, Berlin, Germany.

出版信息

Otol Neurotol. 2012 Apr;33(3):335-42. doi: 10.1097/MAO.0b013e318245cee3.

Abstract

AIM

Postoperative vertigo is a well-known complication after cochlear implantation. The aim of the study was to investigate whether the electrical stimulation of the auditory structures via cochlear implant electrodes can affect the vestibular system and induce vertigo.

MATERIALS AND METHODS

In the first group, 114 patients were surveyed retrospectively via questionnaires to evaluate the occurrence and frequency of sound-induced vertigo after cochlear implantation. In the second group of 26 patients, the effects of electrical stimulation on the vestibular system were studied prospectively.

RESULTS

In the first group of patients without any preoperative sound-induced vertigo (n = 104), 20 patients (18%) reported sound-induced vertigo, which occurred after cochlear implantation. In the second group, an acoustic stimulus delivered via the speech processor of the cochlear implant elicited a vestibular evoked myogenic potential response in 4 of the 26 patients as a sign of vestibular costimulation (of the macula sacculi as part of the otolith organs). Horizontal and vertical nystagmus was triggered, whereas utricular function and postural stability remained unchanged. No correlation was found between C/M levels and the vestibular evoked myogenic potentials and nystagmus responses.

CONCLUSION

Sound-induced vertigo can occur in cochlear implantees. This seems to be primarily caused by electrical costimulation of the sacculus as part of the otolith organs.

摘要

目的

术后眩晕是耳蜗植入后的一种已知并发症。本研究旨在探讨耳蜗植入电极的听觉结构电刺激是否会影响前庭系统并引起眩晕。

材料与方法

在第一组中,通过问卷调查回顾性调查了 114 例患者,以评估耳蜗植入后声音诱发眩晕的发生频率。在第二组 26 例患者中,前瞻性研究了电刺激对前庭系统的影响。

结果

在无术前声音诱发眩晕的第一组患者(n = 104)中,20 例(18%)患者报告了耳蜗植入后出现声音诱发眩晕。在第二组中,通过人工耳蜗言语处理器发出的声学刺激在 26 例患者中的 4 例中诱发了前庭诱发肌源性电位反应,这是前庭共刺激的标志(作为耳石器官一部分的囊斑)。诱发了水平和垂直性眼球震颤,而椭圆囊功能和姿势稳定性保持不变。C/M 水平与前庭诱发肌源性电位和眼球震颤反应之间未发现相关性。

结论

耳蜗植入患者可出现声音诱发眩晕。这似乎主要是由耳石器官一部分的囊斑的电刺激引起的。

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