Department of Otorhinolaryngology, University Hospital Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.
Department of Otorhinolaryngology, University Hospital Hamburg-Eppendorf, Hamburg, Germany.
Eur Arch Otorhinolaryngol. 2024 Sep;281(9):4689-4701. doi: 10.1007/s00405-024-08690-1. Epub 2024 May 20.
Patients suffering from Ménière's disease (MD) experience vertigo, and impairments in hearing and quality of life (QoL). This study aims to investigate the impact of cochlear implantation (CI) on various aspects affecting patients with MD.
A single tertiary centre's CI database for CI recipients with MD between 2014 and 2022 was screened retrospectively. Hearing, vertigo, tinnitus symptoms, and hearing-related QoL were assessed. Pre- and postoperative hearing tests in conjunction with subjective outcome measures by visual analogue scale (VAS) and validated tools such as the Dizziness Handicap Inventory (DHI), Tinnitus Handicap Inventory (THI) and Nijmegen Cochlear Implant Questionnaire (NCIQ), as well as the assessment of the pre- and postoperative Functional Level Scale (FLS) were examined.
Eleven ears were included (median age: 59 years at implantation). Following implantation, there was a significant enhancement in Word Recognition Scores at sound levels of 65 dB and 80 dB compared to before treatment (preop vs. 12 months postop: p = 0.012). However, no significant enhancement was observed for 50 dB. MD-related impairments improved significantly postoperatively, as measured by the VAS (vertigo: p = 0.017; tinnitus: p = 0.042), DHI (p = 0.043), THI (p = 0.043) and NCIQ (p < 0.001). The FLS improved significantly (p = 0.020).
CI has positive effects on all areas examined in our cohort. However, discrimination of speech at low sound pressure levels remained problematic postoperatively. In patients suffering from MD, the prioritized treatment goals include not only improved hearing but also the rehabilitation of vertigo and tinnitus, as well as the enhancement of QoL. Validated instruments are useful screening tools.
梅尼埃病（MD）患者会出现眩晕，并伴有听力和生活质量（QoL）受损。本研究旨在探讨人工耳蜗植入（CI）对 MD 患者受影响各方面的影响。
回顾性筛选 2014 年至 2022 年期间在一家三级中心接受 CI 的 MD 患者的 CI 数据库。评估听力、眩晕、耳鸣症状和听力相关 QoL。检查术前和术后听力测试以及视觉模拟量表（VAS）和经过验证的工具（如眩晕残障程度评定量表（DHI）、耳鸣残疾程度评定量表（THI）和奈梅亨人工耳蜗植入问卷（NCIQ））的主观结果测量，以及术前和术后功能水平量表（FLS）的评估。
共纳入 11 只耳朵（植入时的中位年龄为 59 岁）。植入后，与治疗前相比，在 65 dB 和 80 dB 的声音水平下，言语识别得分有显著提高（术前 vs. 术后 12 个月：p=0.012）。然而，在 50 dB 时未观察到显著提高。VAS（眩晕：p=0.017；耳鸣：p=0.042）、DHI（p=0.043）、THI（p=0.043）和 NCIQ（p<0.001）测量的 MD 相关障碍在术后显著改善。FLS 显著改善（p=0.020）。
CI 对我们队列中检查的所有领域都有积极影响。然而，术后在低声压级下辨别言语仍存在问题。在 MD 患者中，优先治疗目标不仅包括改善听力，还包括眩晕和耳鸣的康复以及 QoL 的提高。经过验证的工具是有用的筛查工具。
