Ayas Muhammed, Muzaffar Jameel, Phillips Veronica, Smith Mathew E, Borsetto Daniele, Bance Manohar L
College of Health Sciences, University of Sharjah, Sharjah P.O. Box 27272, United Arab Emirates.
Department of Clinical Neurosciences, University of Cambridge, Cambridge CB2 1TN, UK.
J Clin Med. 2024 Nov 20;13(22):6996. doi: 10.3390/jcm13226996.
Cochlear implantation (CI) is an effective intervention for individuals with severe to profound hearing loss; however, it may impact vestibular function due to its proximity to related anatomical structures. Vestibular evoked myogenic potentials (VEMPs) assess the function of the saccule and utricle, critical components of the vestibular system. This review examines CI's impact on air conduction (AC) and bone conduction (BC) VEMP responses. A scoping review was conducted following PRISMA guidelines, using databases such as Medline, Embase, Cochrane Library, Scopus, and ProQuest Dissertations. Studies reporting on AC and/or BC-VEMP in CI recipients were included. Data extraction focused on VEMP response rates, amplitudes, and latencies pre- and post-CI. Risk of bias/quality assessment was performed using the Newcastle-Ottawa Scale. Out of 961 studies identified, 4 met the inclusion criteria, encompassing a total of 245 CI-implanted ears. Results indicated that AC-VEMP responses were often reduced or absent post-CI, reflecting the influence of surgical changes in the middle ear mechanics rather than otolith dysfunction. In contrast, BC-VEMP responses were more consistently preserved, suggesting that BC stimuli bypass the middle ear and more accurately delineate otolith function. Variations in VEMP outcomes were noted depending on the surgical approach and individual patient factors. CI impacts vestibular function as measured by VEMP, with AC-VEMP showing greater susceptibility to postoperative changes compared to BC-VEMP. The presence of preserved BC-VEMP alongside absent AC-VEMP underscores the need to differentiate between these measures in assessing vestibular function.
人工耳蜗植入（CI）是对重度至极重度听力损失患者的一种有效干预措施；然而，由于其靠近相关解剖结构，可能会影响前庭功能。前庭诱发肌源性电位（VEMP）可评估球囊和椭圆囊的功能，这两者是前庭系统的关键组成部分。本综述探讨了CI对气导（AC）和骨导（BC）VEMP反应的影响。按照PRISMA指南进行了一项范围综述，使用了诸如Medline、Embase、Cochrane图书馆、Scopus和ProQuest学位论文等数据库。纳入了报告CI接受者AC和/或BC-VEMP情况的研究。数据提取重点关注CI前后的VEMP反应率、振幅和潜伏期。使用纽卡斯尔-渥太华量表进行偏倚风险/质量评估。在961项识别出的研究中，4项符合纳入标准，共涉及245只接受CI植入的耳朵。结果表明，CI后AC-VEMP反应常常减弱或消失，这反映了中耳力学手术改变的影响，而非耳石功能障碍。相比之下，BC-VEMP反应更一致地得以保留，这表明骨导刺激绕过了中耳，能更准确地描绘耳石功能。根据手术方式和个体患者因素，VEMP结果存在差异。CI会影响通过VEMP测量的前庭功能，与BC-VEMP相比，AC-VEMP对术后变化更敏感。BC-VEMP保留而AC-VEMP消失的情况凸显了在评估前庭功能时区分这些测量方法的必要性。
