Piker Erin G, Riska Kristal, Garrison Doug, Kaylie David M
Department of Communication Sciences and Disorders James Madison University Harrisonburg Virginia USA.
Department of Head and Neck Surgery and Communication Sciences Duke University School of Medicine Durham North Carolina USA.
Laryngoscope Investig Otolaryngol. 2020 Jun 4;5(3):560-571. doi: 10.1002/lio2.413. eCollection 2020 Jun.
The purpose of this study was to assess the effects of cochlear implantation on the functional integrity of the horizontal semicircular canal using multiple methodologies, and to discuss and highlight the limitations of using isolated vestibular tests to assess vestibular function in surgical ears.
Ten cochlear implant patients were consented to undergo a preoperative and 3-month postoperative vestibular assessment. The horizontal semicircular canal (SCC) was assessed using three different vestibular test measures that assess function using different stimuli and at different frequencies ranges: caloric testing, sinusoidal harmonic acceleration testing in the rotary chair, and video head impulse testing in the plane of the horizontal SCC. Data was analyzed using different methods: descriptive, statistical, and by an examination of individual case studies.
Each analysis method yielded a different interpretation. Statistical analysis showed no significant group mean differences between baseline pre-op vestibular test results and 3-month post-op vestibular test results. Descriptive analysis showed 30% of individuals presented with postoperative abnormal vestibular testing findings. A case study examination showed that only one patient presented with a post-op decrease in vestibular function in the implanted ear.
There are several limitations of conventional vestibular testing in postsurgical cochlear implant patients. A test-battery approach, including case history, and test interpretation made on a case-by-case basis is needed to determine whether the patient has undergone vestibular damage, is at risk for falling, or in need of further management.
2b individual cohort study.
本研究旨在使用多种方法评估人工耳蜗植入对水平半规管功能完整性的影响，并讨论和强调使用孤立的前庭测试评估手术耳前庭功能的局限性。
10名人工耳蜗植入患者同意接受术前和术后3个月的前庭评估。使用三种不同的前庭测试方法评估水平半规管（SCC），这些方法使用不同的刺激并在不同的频率范围内评估功能：冷热试验、转椅中的正弦谐波加速度试验以及水平SCC平面内的视频头脉冲试验。使用不同的方法分析数据：描述性分析、统计分析以及对个体病例研究的检查。
每种分析方法都得出了不同的解释。统计分析表明，术前前庭测试基线结果与术后3个月前庭测试结果之间，组平均差异无统计学意义。描述性分析表明，30%的个体术后前庭测试结果异常。病例研究检查表明，只有一名患者植入耳的前庭功能术后下降。
在人工耳蜗植入术后患者中，传统前庭测试存在若干局限性。需要采用包括病史在内的综合测试方法，并根据具体情况进行测试解读，以确定患者是否发生了前庭损伤、是否有跌倒风险或是否需要进一步治疗。
2b级个体队列研究。
