Download 13th International Conference on Cochlear Implants and Other

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Transcript
P2-11 Complications
P2-11-1
Correlation of vestibular testing with subjective symptoms before and after cochlea implantation
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Kunze E. , Veraguth D. , Hegemann S. , Monge Naldi A.
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Universitätsspital Zürich, ORL Klinik, Zürich, Switzerland
Objectives: To quantify the incidence of vestibular dysfunction in patients after cochlear implantation in our clinic
and to evaluate the presence of dizziness symptoms before and after implantation we performed a retrospective
study.
Methods: From October 2011 until May 2013 64 patients received a cochlear implant at the University Hospital
Zurich. 4 patients had a revision done of the implant and no vestibular testing either pre- or postoperative. 3
patients had no or only partial preoperative vestibular testing and 18 patients had no or only partial postoperative
vestibular testing. In this retrospective study, 39 patients with pre- and postoperative vestibular function tests (all
tests or only 1 test missing) aged 19 to 84 years undergoing unilateral cochlear implantation were included. Four
different implants were used and operation was performed via a retroauricular transmastoidal approach. Preand postoperative vestibular function was measured by video-documented horizontal head impulse test (HIT),
dynamic visual acuity (DVA), caloric irrigation of the outer hearing channel, cervical (cVEMP) and ocular
vestibular evoked myogenic potentials (oVEMP), vertigo or imbalance symptoms were documented.
Results: 20 of 39 patients suffered from postoperative dizziness, 10 of them with new onset. Compared to the
group without any dizziness before and after cochlea implantation (18%), there is no higher incidence of
pathologic test results in the „new dizziness group“ (21%), with the exception of caloric testing (0% in the never
dizziness group versus 33% in the new dizziness group). Tests of the horizontal canal (HIT, DVA) and the
oVEMPs showed comparable results between these two groups, whereas the cVEMPS interestingly were
significantly more often pathologic in the group without dizziness (46% to 22%). Patients with dizziness in the
pre- and postoperative period exhibited the highest prevalence of newly detected pathologic test results (34%),
half of the patients featured a newly pathologic DVA. 13% (5/39) of the entire group even reported total absence
of dizziness after the implantation in contrast to the preoperative situation.
Conclusion: Vestibular dysfunction after cochlea implantation occurs in patients with dizziness symptoms
similar to patients without any previous suffering. Vestibular function testing before and after cochlea
implantation does not correlate with the subjective symptom of dizziness. In our retrospective study there was no
single test correlating with the patient's symptoms. However cVEMPs were increased in the group without any
dizziness and should therefore not be used as a single test for vestibular testing.
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