Gupta Atul, Raj Poonam
Department of ENT and HNS, Base Hospital Delhi Cantt, New Delhi, 110010 India.
2Department of ENT and HNS, Army Hospital (R&R), New Delhi, 110010 India.
Indian J Otolaryngol Head Neck Surg. 2018 Jun;70(2):200-204. doi: 10.1007/s12070-017-1054-0. Epub 2017 Jan 7.
Children with sensorineural hearing loss have risk of surgically induced vestibular dysfunction post cochlear implantation due to instrumentation. It is clinically important to estimate the risk of vestibular loss post cochlear implant so the patient can be made fully aware of these risks when considering cochlear implantation. The aim of the study was to identify compensated vestibular dysfunction post cochlear implantation. Vestibular function was evaluated both pre and post CI using monothermal warm air caloric testing. Recordings were made using head band camera on SYNAPSYS Ulmer VNG software. 'Monothermal caloric asymmetry' (MCA) was depicted as 'unilateral weakness' based on the slow phase velocity of nystagmus. MCA of >15% was taken as evidence of canal paresis. The incidence of compensated vestibular dysfunction post CI surgery was found to be 16.66%. The results were statistically significant ( value 0.02) and indicated worsening of canal paresis indicative of vestibular dysfunction. Children for cochlear implantation should undergo evaluation of their vestibular system pre and post surgery. Caution should be exercised before planning bilateral cochlear implantation in the same sitting.
感音神经性听力损失儿童在人工耳蜗植入术后因手术操作有发生前庭功能障碍的风险。评估人工耳蜗植入术后前庭功能丧失的风险在临床上很重要,这样患者在考虑人工耳蜗植入时就能充分了解这些风险。本研究的目的是识别人工耳蜗植入术后代偿性前庭功能障碍。在人工耳蜗植入术前和术后使用单温暖空气冷热试验评估前庭功能。使用头戴式摄像头在SYNAPSYS乌尔姆视频眼震图软件上进行记录。根据眼震慢相速度,将“单温冷热不对称”(MCA)描述为“单侧减弱”。MCA>15%被视为半规管麻痹的证据。人工耳蜗植入术后代偿性前庭功能障碍的发生率为16.66%。结果具有统计学意义(P值0.02),表明半规管麻痹加重,提示前庭功能障碍。拟接受人工耳蜗植入的儿童应在手术前后进行前庭系统评估。在计划同一次手术中进行双侧人工耳蜗植入前应谨慎行事。