Ramos-de-Miguel Ángel, Sluydts Morgana, Falcón Juan Carlos, Manrique-Huarte Raquel, Rodriguez Isaura, Zarowski Andrzej, Barbara Maurizio, Manrique Manuel, Borkoski Silvia, Lorente Joan, Leblanc Marc, Rambault Antonin, Van Baelen Erika, Van Himbeeck Carl, Huarte Alicia, Macías Ángel Ramos
Unit of Hearing Loss, Department of Otorhinolaryngology, Head and Neck, Complejo Hospitalario Universitario Insular Materno Infantil, Las Palmas of Gran Canaria, Spain.
Universidad Las Palmas de Gran Canaria, Las Palmas of Gran Canaria, Spain.
Front Neurol. 2025 Jan 30;16:1520554. doi: 10.3389/fneur.2025.1520554. eCollection 2025.
This study evaluates cochleovestibular implants (CVI) for improving auditory and vestibular function in patients with bilateral vestibulopathy and severe-to-profound hearing loss. CVI uniquely combines auditory and vestibular stimulation, offering a potential solution for dual impairments in hearing and balance.
Ten patients underwent CVI implantation. Auditory function was assessed with pure-tone audiometry (PTA) and speech recognition at baseline, 3, and 9 months post-implantation. Vestibular function was measured using the Dynamic Gait Index (DGI), Sensory Organization Test (SOT), posturography, and the Dizziness Handicap Inventory (DHI). Placebo-controlled tests verified cochleovestibular stimulation specificity.
Auditory outcomes showed PTA improvements from 78 dB HL preoperatively to 34 dB HL at 3 months and 36 dB HL at 9 months, alongside speech recognition gains. Vestibular improvements included significant DGI ( < 0.05) and SOT score increases (33% to 68%, < 0.05). DHI scores reflected reduced dizziness-related disability. Residual balance gains after device deactivation suggest neural adaptation, and placebo tests confirmed cochleovestibular stimulation specificity.
CVI effectively restores auditory and vestibular function, with improvements in hearing, balance, and quality of life. Neural plasticity likely supports long-term benefits. Future research should refine device design and stimulation protocols to enhance outcomes further.
本研究评估了人工耳蜗前庭植入物（CVI）对双侧前庭病变和重度至极重度听力损失患者听觉和前庭功能的改善情况。CVI独特地结合了听觉和前庭刺激，为听力和平衡双重障碍提供了一种潜在的解决方案。
10名患者接受了CVI植入。在植入前、植入后3个月和9个月，通过纯音听力测定（PTA）和言语识别评估听觉功能。使用动态步态指数（DGI）、感觉组织测试（SOT）、姿势描记法和头晕残障量表（DHI）测量前庭功能。安慰剂对照测试验证了耳蜗前庭刺激的特异性。
听觉结果显示，PTA从术前的78 dB HL改善到3个月时的34 dB HL和9个月时的36 dB HL，同时言语识别能力提高。前庭功能的改善包括DGI显著提高（P<0.05）和SOT评分增加（33%至68%，P<0.05）。DHI评分反映了与头晕相关的残疾程度降低。设备停用后的残余平衡改善表明存在神经适应，安慰剂测试证实了耳蜗前庭刺激的特异性。
CVI有效地恢复了听觉和前庭功能，改善了听力、平衡和生活质量。神经可塑性可能支持长期益处。未来的研究应改进设备设计和刺激方案，以进一步提高治疗效果。
