Int Tinnitus J. 2020 Nov 18;24(1):xxx-xx. doi: 10.5935/0946-5448.20200006.
Patients with profound Sensorineural Hearing Loss (SNHL) are susceptible to vestibular disturbances following Cochlear Implant (CI) surgery. This study aimed to evaluate vestibular dysfunctions following unilateral CI in the congenitally deaf children.
This was a cross-sectional study conducted on 24 children (mean age: 10.56 ± 5.49 years old) who underwent unilateral CI and 24 age-matched controls (mean age: 11.13 ± 6.21 years old). Vestibular functions were assessed by Vestibular Evoked Myogenic Potential (VEMP) and Computerized Dynamic Posturography (CDP). The VEMP test was performed for otolith's function (especially saccule) evaluation. Sensory Organization Test (SOT) protocol of CDP was also utilized to differentiate the role of various sensory systems contributing to postural stability. In addition, total equilibrium score was calculated. The variables were comparatively assessed between the two groups.
The mean p13-n23 amplitude in the CI users was significantly lower than the controls (p<0.05). However, the two groups showed no significant difference in cVEMP latency values (p>0.05). The SOT analysis revealed that 45.83% (11/24) of the CI subjects had some kind of sensory abnormalities: 7 cases (29.17%) vestibular, 2 cases (8.33%) visual, 2 cases (8.33%) vestibular and somatosensory involvements. Furthermore, total equilibrium score was significantly reduced in implanted group than the controls (p<0.001). At least, 70.59% (12/24) CI patients showed abnormal values in the CDP or cVEMP examinations.
This study shows functional vestibular impairments in children who underwent CI. These patients showed significantly increased postural instability which was more evident in dynamic conditions. These findings provide the basis for better pre-operative counseling and postoperative vestibular rehabilitation to CI recipients.
患有深度感音神经性听力损失（SNHL）的患者在接受人工耳蜗植入（CI）手术后易出现前庭功能障碍。本研究旨在评估先天性耳聋儿童单侧 CI 术后的前庭功能障碍。
这是一项横断面研究，纳入了 24 名单侧 CI 患者（平均年龄：10.56±5.49 岁）和 24 名年龄匹配的对照组（平均年龄：11.13±6.21 岁）。通过前庭诱发肌源性电位（VEMP）和计算机动态姿势描记术（CDP）评估前庭功能。VEMP 测试用于评估耳石功能（特别是球囊）。还利用 CDP 的感觉组织测试（SOT）方案来区分对姿势稳定性有贡献的各种感觉系统的作用。此外，计算了总平衡评分。比较了两组间的变量。
CI 使用者的 p13-n23 振幅平均值明显低于对照组（p<0.05）。然而，两组的 cVEMP 潜伏期值无显著差异（p>0.05）。SOT 分析显示，45.83%（11/24）的 CI 受试者存在某种感觉异常：7 例（29.17%）为前庭异常，2 例（8.33%）为视觉异常，2 例（8.33%）为前庭和躯体感觉异常。此外，植入组的总平衡评分明显低于对照组（p<0.001）。至少有 70.59%（12/24）的 CI 患者在 CDP 或 cVEMP 检查中出现异常值。
本研究显示接受 CI 的儿童存在功能性前庭损伤。这些患者表现出明显的姿势不稳，在动态条件下更为明显。这些发现为 CI 接受者提供了更好的术前咨询和术后前庭康复的基础。
