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人工耳蜗对前庭诱发肌源性电位反应及姿势稳定性的影响。

The effect of cochlear implants on vestibular-evoked myogenic potential responses and postural stability.

作者信息

Miwa Toru, Minoda Ryosei, Matsuyoshi Hidetake, Takeda Hiroki

机构信息

Department of Otolaryngology and Head and Neck Surgery, Graduate School of Medicine, Kumamoto University, Kumamoto, Japan; Otolaryngology-Head and Neck Surgery, Kumamoto General Hospital, Kumamoto, Japan.

Otolaryngology-Head and Neck Surgery, Kumamoto General Hospital, Kumamoto, Japan.

出版信息

Auris Nasus Larynx. 2019 Feb;46(1):50-57. doi: 10.1016/j.anl.2018.06.002. Epub 2018 Jun 20.

Abstract

OBJECTIVE

Current spread by electrical stimulation via inserted cochlear implant (CI) electrodes and the consequential increase in sound input can affect the equilibrium of patients. The aim of the present study was to clarify the effect of CIs on the equilibrium of patients through cervical vestibular-evoked myogenic potential (cVEMP) testing and static stabilometry performed with the CIs turned on (CI-on) and off (CI-off).

METHODS

This prospective study included nine adult patients who underwent unilateral cochlear implantation surgery at our institution. cVEMP testing and stabilometry were performed before surgery and repeated after surgery in the CI-on and CI-off modes.

RESULTS

Before surgery, cVEMP responses were diminished in five of the nine patients (55.6%), while the results of stabilometry were poor in six patients (66.7%). After surgery, both cVEMP responses and stabilometry findings in the CI-off mode exhibited significant deterioration relative to the preoperative results (cVEMP: 7/9, 77.8%; stabilometry: 7/9, 77.8%). However, in the CI-on mode, there were significant improvements in both test results relative to the findings in the CI-off mode for all patients.

CONCLUSION

CIs compensated for the surgical trauma-induced deterioration in static postural stability when turned on, resulting in a considerable improvement. Our findings suggest that postoperative cVEMP testing in the CI-on and CI-off modes will enable more accurate assessment of the saccule-inferior vestibular nerve system function after cochlear implant surgery.

摘要

目的

通过植入的人工耳蜗(CI)电极进行电刺激所导致的电流传播以及随之而来的声音输入增加,可能会影响患者的平衡。本研究的目的是通过在人工耳蜗开启(CI-on)和关闭(CI-off)状态下进行颈前庭诱发肌源性电位(cVEMP)测试和静态平衡测试,来阐明人工耳蜗对患者平衡的影响。

方法

这项前瞻性研究纳入了9名在我们机构接受单侧人工耳蜗植入手术的成年患者。在手术前进行cVEMP测试和平衡测试,并在手术后以CI-on和CI-off模式重复进行。

结果

手术前,9名患者中有5名(55.6%)的cVEMP反应减弱,而6名患者(66.7%)的平衡测试结果较差。手术后,CI-off模式下的cVEMP反应和平衡测试结果相对于术前结果均表现出显著恶化(cVEMP:7/9,77.8%;平衡测试:7/9,77.8%)。然而,在CI-on模式下,所有患者的两项测试结果相对于CI-off模式下的结果均有显著改善。

结论

人工耳蜗开启时可补偿手术创伤引起的静态姿势稳定性恶化,从而带来显著改善。我们的研究结果表明,在CI-on和CI-off模式下进行术后cVEMP测试将能够更准确地评估人工耳蜗植入手术后球囊-前庭下神经系统的功能。

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