Ear, Nose and Throat Department, Tzanion General Hospital, 1 Zanni & Afentouli, 18536 Piraeus, Greece.
Eur Arch Otorhinolaryngol. 2013 Feb;270(2):489-95. doi: 10.1007/s00405-012-1950-6. Epub 2012 Apr 6.
The aim of the present study was to examine the influence of cochlear implantation on vestibular function. The function of the horizontal semicircular canal, the saccular function, and the incidence of vestibular symptoms were assessed before and after cochlear implantation. Twenty unilaterally cochlear implant patients were evaluated preoperatively, 1 and 6 months postoperatively, with caloric testing with electronystagmography (ENG) recordings and vestibular evoked myogenic potentials (VEMP) testing. A medical history was taken from every subject, noting the presence or absence of vertigo before and after the operation. A possible correlation between the appearance of postoperative vertigo and age, sex, implant side, preoperative caloric results and VEMP status, and postoperatively recorded changes in caloric and VEMP testing was also investigated. A statistically significant difference was found in the percentages of canal paresis (p = 0.01) and the percentages of VEMP waveform absence (p = 0.002) between the repeated measurements in the implanted side, whereas in the non-implanted side no difference was (p > 0.05) found. Four patients complained of postoperative vestibular symptoms. In three of them the symptoms lasted less than 6 months postoperatively, but the fourth patient was still dizzy 6 months after cochlear implantation. No correlation was found between the above-mentioned factors and the occurrence of postoperative vertigo. In conclusion, although changes of the peripheral vestibular function of the implanted side were recorded in our patients, permanent vertigo was rare. Predictive factors for the occurrence of postoperative vestibular symptoms could not be identified.
本研究旨在探讨人工耳蜗植入对前庭功能的影响。在人工耳蜗植入术前、术后 1 个月和 6 个月，通过眼震电图（ENG）记录和前庭诱发肌源性电位（VEMP）测试评估水平半规管功能、囊状功能和前庭症状的发生率。对 20 例单侧人工耳蜗植入患者进行评估，每位患者均接受病史调查，记录手术前后是否存在眩晕。还调查了术后眩晕的出现与年龄、性别、植入侧、术前冷热结果和 VEMP 状态以及术后记录的冷热和 VEMP 测试变化之间的可能相关性。植入侧的重复测量中发现了管麻痹百分比（p = 0.01）和 VEMP 波幅缺失百分比（p = 0.002）的统计学显著差异，而在非植入侧未发现差异（p > 0.05）。有 4 名患者诉术后出现前庭症状。其中 3 名患者的症状持续时间短于术后 6 个月，但第 4 名患者在人工耳蜗植入后 6 个月仍感到头晕。未发现上述因素与术后眩晕的发生有相关性。总之，尽管我们的患者记录到植入侧外周前庭功能发生变化，但永久性眩晕很少见。无法确定术后前庭症状发生的预测因素。
