Sluydts Morgana, De Laet Chloë, De Coninck Liesbeth, Blaivie Catherine, van Dinther Joost J S, Offeciers Erwin, Wuyts Floris L, Zarowski Andrzej
Ear-Nose-Throat Department, European Institute for Otorhinolaryngology, Head and Neck Surgery, Antwerp, Belgium.
Lab for Equilibrium Investigations and Aerospace, Faculty of Sciences, University of Antwerp, Antwerp, Belgium.
Front Neurol. 2023 Aug 25;14:1248715. doi: 10.3389/fneur.2023.1248715. eCollection 2023.
In a previous manuscript from our research group, the concept of vestibular co-stimulation was investigated in adult subjects who received a cochlear implant (CI). Despite what literature reports state, no signs of vestibular co-stimulation could be observed.
In this case report, it was described how a woman, who previously underwent a neurectomy of the left vestibular nerve and suffers from bilateral vestibulopathy (BVP), reported improved balance whenever her CI on the left was stimulating. Unexpectedly, the sway analyses during posturography indeed showed a clinically relevant improvement when the CI was activated.
Vestibular co-stimulation as a side effect of CI stimulation could not be the explanation in this case due to the ipsilateral vestibular neurectomy. It is more likely that the results can be attributed to the electrically restored auditory input, which serves as an external reference for maintaining balance and spatial orientation. In addition, this patient experienced disturbing tinnitus whenever her CI was deactivated. It is thus plausible that the tinnitus increased her cognitive load, which was already increased because of the BVP, leading to an increased imbalance in the absence of CI stimulation.
在我们研究小组之前的一篇手稿中，对接受人工耳蜗植入（CI）的成年受试者的前庭联合刺激概念进行了研究。尽管文献报道如此，但未观察到前庭联合刺激的迹象。
在本病例报告中，描述了一名曾接受左侧前庭神经切除术且患有双侧前庭病变（BVP）的女性，每当她左侧的人工耳蜗受到刺激时，其平衡感都会有所改善。出乎意料的是，在姿势描记术中的摇摆分析确实显示，当人工耳蜗被激活时，在临床上有显著改善。
由于同侧前庭神经切除术，在这种情况下，人工耳蜗刺激的副作用即前庭联合刺激不可能是其原因。更有可能的是，结果可归因于电恢复的听觉输入，它作为维持平衡和空间定向的外部参考。此外，该患者每当人工耳蜗停用就会经历令人困扰的耳鸣。因此，耳鸣增加了她的认知负荷，而由于双侧前庭病变，这种认知负荷本已增加，这导致在人工耳蜗未受刺激时失衡加剧，这似乎是合理的。
