Vestibular function assessment in cochlear implant users with inner ear

Vestibular function assessment in cochlear implant users with inner ear
anomalies
Author(s): Emamdjomeh, H.; Asghari A.m; Farhadi, M.; Daneshi,
A.;Hosseinzadeh,F

Introduction: Because of the importance of vestibular function in gross motor development, otologists and audiologists should recognize and understand the high incidence of vestibular dysfunction in hearing impaired patients and be prepared to undertake appropriate intervention. However, there have been no studies that investigated the entire vestibular function in patients with inner ear anomalies whom undergone cochlear implantation. Objective: To identify vestibular
dysfunction in patients with inner ear anomalies with severe to profound sensorineural hearing loss (SNHL) and cochlear implant surgery. Material and methods: This is a retrospective case review study of patients with unilateral cochlear implantation from 2001 to 28 .2016 patients with congenital inner ear anomalies whom underwent cochlear implantation were selected, and were compared to 16 cochlear implanted patients with severe to profound hearing loss and normal inner ear anatomy. Inner ear anatomy was evaluated by temporal bone high resolution computed tomography (HRCT).Vestibular function was assessed by Computerized Dynamic Posturography (CDP) and Bruininks–Oseretsky test (BOT2-). Binary Logistic Regression with SPSS and Fisher Exact test were used for data analysis. Results: In this study, patients with inner ear anomalies showed significantly worse performance in BOT2- scores, 13 times more compared to normal group (p-value: 0.02). Data supported that as severity of abnormality increases, patients faced more vestibular dysfunction. Balance as measured by posturography, showed 5.91 times higher vestibular dysfunction (p-value: 0.012) in patients with inner ear anomalies in comparison with control group. Also, higher prevalence of vestibular dysfunction was found in patients with abnormal internal auditory canal. Gender, age, duration of implantation, age of implantation, reimplantation, type of prosthesis and intra-operative CSF gusher had no significant effects on vestibular function. Conclusion: Vestibular disturbance is more identified in patients with inner ear anomalies. BOT2- and posturography are simple, fast and efficient test to screen patients with vestibular dysfunction especially those with inner ear anomalies. Early identification and rehabilitation and appropriate intervention can minimize the risk of injury in these patients.