Vaz Fabiane de Castro, Petrus Leonardo, Martins Wagner Rodrigues, Silva Isabella Monteiro de Castro, Lima Jade Arielly Oliveira, Santos Nycolle Margarida da Silva, Turri-Silva Natália, Bahmad Fayez
Postgraduate Program in Health Sciences at the Faculty of Health Sciences, University of Brasília, Brasília, DF, Brazil.
3ID Ensino, 3 ID Prevenção e Reabilitação Geriátrica, Brasília, DF, Brazil.
Front Neurol. 2022 Aug 10;13:947589. doi: 10.3389/fneur.2022.947589. eCollection 2022.
The findings in literature indicate inconsistency in the complications caused by the implant of electrodes in the cochlea; vestibular alterations and balance disorders are mentioned as the most likely.
To evaluate, in literature, through the results of multiple vestibular function tests, the effects of cochlear implant surgery on postural stability in adult patients and to analyze.
From the PICO strategy, where the Population focuses on adults, Intervention is cochlear implant surgery, Comparisons are between implanted patients, and Outcomes are the results of the assessment of cochlear function, the research question was formulated: Are there deficits in vestibular function in adults undergoing cochlear implant placement?
Systematic review based on cohort, case-control, and cross-sectional observational studies. Information sources: Databases between 1980 and 2021, namely, PubMed, Cinahl, Web Of Science, Cochrane, and Scopus. Search strategy using Mesh terms: "Adult," "Cochlear Implant," "Postural Balance," "Posturography," "Cochlear Implant," "Dizziness," "Vertigo," "Vestibular Functional Tests,"and "Caloric Tests." Populational inclusion criteria: studies with adult patients; intervention: cochlear implant placement surgery; comparison: analysis of a vestibular function with vestibular test results and pre- and postoperative symptoms; outcome: studies with at least one of the vestibular function tests, such as computerized vectoelectronystagmography (VENG), vestibular-evoked myogenic potentials (VEMPs), caloric test, video head impulse test (VHIT), head impulse test (HIT), videonystagmography, (VNG) and static and dynamic posturography. Exclusion criteria: studies without records of pre- and postoperative data collection and studies with populations under 18 years of age. Screening based on the reading of abstracts and titles was performed independently by two reviewers. In the end, with the intermediation of a third reviewer, manuscripts were included. Risk of bias analysis, performed by two other authors, occurred using the JBI "Critical Appraisal Checklist."
Of the 757 studies, 38 articles met the inclusion criteria. VEMP was the most commonly used test by the studies (44.7%), followed by the caloric test (36.8%) and vHIT (23.6%). Most studies performed more than one test to assess vestibular function.
Among all vestibular tests investigated, the deleterious effects on vestibular function after cochlear implant surgery were detected with statistical significance ( < 0.05) using VEMP and caloric test. Comparing abnormal and normal results after implant surgery, the vestibular apparatus was evaluated as having abnormal results after cochlear implant surgery only in the VEMP test. The other tests analyzed maintained a percentage mostly considered normal results.
identifier: CRD42020198872.
文献中的研究结果表明，耳蜗植入电极所引发的并发症存在不一致性；前庭改变和平衡障碍被认为是最有可能出现的情况。
通过多项前庭功能测试的结果，在文献中评估人工耳蜗植入手术对成年患者姿势稳定性的影响并进行分析。
根据PICO策略（其中人群聚焦于成年人，干预措施是人工耳蜗植入手术，对照是植入患者之间的比较，结果是耳蜗功能评估的结果），提出了研究问题：接受人工耳蜗植入的成年人是否存在前庭功能缺陷？
基于队列研究、病例对照研究和横断面观察性研究进行系统评价。信息来源：1980年至2021年期间的数据库，即PubMed、Cinahl、科学网、考科蓝图书馆和Scopus。使用医学主题词的检索策略：“成年人”“人工耳蜗”“姿势平衡”“姿势描记法”“人工耳蜗”“头晕”“眩晕”“前庭功能测试”和“冷热试验”。人群纳入标准：针对成年患者的研究；干预措施：人工耳蜗植入手术；对照：通过前庭测试结果以及术前和术后症状对前庭功能进行分析；结果：至少进行一项前庭功能测试的研究，如计算机化矢量眼震图（VENG）、前庭诱发肌源性电位（VEMP）、冷热试验、视频头脉冲试验（VHIT）、头脉冲试验（HIT）、眼震电图（VNG）以及静态和动态姿势描记法。排除标准：未记录术前和术后数据收集情况的研究以及针对18岁以下人群的研究。由两名评审员独立根据摘要和标题进行筛选。最后，在第三名评审员的协调下纳入稿件。由另外两名作者使用JBI“关键评价清单”进行偏倚风险分析。
在757项研究中，38篇文章符合纳入标准。VEMP是研究中最常用的测试（44.7%），其次是冷热试验（36.8%）和视频头脉冲试验（23.6%）。大多数研究进行了不止一项测试来评估前庭功能。
在所有研究的前庭测试中，使用VEMP和冷热试验检测到人工耳蜗植入手术后对前庭功能的有害影响具有统计学意义（<0.05）。比较植入手术后的异常和正常结果，仅在VEMP测试中，人工耳蜗植入手术后前庭器官的评估结果为异常。其他分析的测试大多保持了被认为是正常结果的百分比。
标识符：CRD42020198872。
