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单侧人工耳蜗植入治疗重度感音神经性听力损失后的前庭功能

Vestibular function following unilateral cochlear implantation for profound sensorineural hearing loss.

作者信息

le Nobel Gavin J, Hwang Euna, Wu Adrian, Cushing Sharon, Lin Vincent Y

机构信息

Department of Otolaryngology Head and Neck Surgery, University of Toronto, 190 Elizabeth Street, Rm 3S438, RFE building, Toronto, ON, M5G2N2, Canada.

University of Toronto, Toronto, ON, Canada.

出版信息

J Otolaryngol Head Neck Surg. 2016 Jun 14;45(1):38. doi: 10.1186/s40463-016-0150-6.

Abstract

BACKGROUND

Many Canadians are affected by sensorineural hearing loss (SNHL) and those with severe or profound hearing loss may have poor hearing function despite optimized hearing aids. Cochlear implants (CI) offer effective hearing rehabilitation for these patients, however, concern continues to exist regarding possible effects of CI on the vestibular system and balance. The objective of this study was to conduct a pilot study assessing the effects of unilateral cochlear implantation (CI) on balance and the vestibular system in post-lingually deafened adults.

METHODS

Twelve patients were included in this pilot study and were assessed pre-operatively and at immediate, 1 week, and 1 month post-operative intervals. Assessments consisted of the dizziness handicap inventory (DHI), subjective visual vertical (SVV), and timed up-and-go testing (TUG). When applicable, testing was repeated with the CI on and off.

RESULTS

Many patients were found to have deviated SVV at pre-operative and post-operative assessments. However, statistically significant changes were not seen when comparing pre-operative and post-operative SVV or when comparing SVV with the CI on and with the CI off. DHI was found to improve in five patients and worsen in two patients, however, no statistically significant change was found in DHI scores or with TUG testing.

CONCLUSIONS

This current pilot study does not indicate that CI surgery or implant activity influence vestibular or balance function, however, this pilot study is underpowered and greater numbers of patients would need be assessed to confirm these findings.

摘要

背景

许多加拿大人受到感音神经性听力损失(SNHL)的影响,那些重度或极重度听力损失患者即使使用了优化的助听器,听力功能可能仍较差。人工耳蜗(CI)为这些患者提供了有效的听力康复方法,然而,对于CI对前庭系统和平衡可能产生的影响,人们仍存在担忧。本研究的目的是进行一项初步研究,评估单侧人工耳蜗植入(CI)对语后聋成年人平衡和前庭系统的影响。

方法

本初步研究纳入了12名患者,在术前以及术后即刻、1周和1个月时进行评估。评估包括头晕残障量表(DHI)、主观视觉垂直线(SVV)和计时起立行走测试(TUG)。在适用的情况下,分别在CI开启和关闭时重复进行测试。

结果

许多患者在术前和术后评估中均发现SVV有偏差。然而,比较术前和术后的SVV,以及比较CI开启和关闭时的SVV时,未发现有统计学意义的变化。发现5名患者的DHI有所改善,2名患者的DHI恶化,然而,DHI评分或TUG测试均未发现有统计学意义的变化。

结论

当前的这项初步研究并未表明CI手术或植入物活动会影响前庭或平衡功能,然而,这项初步研究的样本量不足,需要评估更多患者以证实这些发现。

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