Long-Term Impact of Cochlear Implants on Vestibular Function in Adults and Children
DOI:
https://doi.org/10.63682/jns.v13i1.9607Keywords:
Cochlear implant; Vestibular function, vHIT, VEMP, Caloric test, Balance, Adults, Children, Long-term outcomesAbstract
Background: Cochlear implants are a standard intervention for profound hearing loss. The benefits of hearing improvements post-implant are undeniable. However, the long-term effects on balance and vestibular function and balance pathways remain a concern. The vestibular organs and cochlea are interconnected, so knowing the effects of cochlear implants on the vestibular organs balance function integration will result in improved care and system development. Understanding how implantation affects balance and vestibular pathways in both adults and children is essential for improving long-term care.
Methodology: This study included 72 participants who underwent unilateral cochlear implantation between October 2023 and October 2024 at Jhalawan Medical College Khuzdar. A observational design was used. Vestibular function was assessed before implantation and again 12 months after surgery. The test battery included the video head impulse test (vHIT), cervical and ocular vestibular evoked myogenic potentials (cVEMP/oVEMP), caloric irrigation, Romberg test, and timed up-and-go (TUG). Demographic variables such as age, sex, diagnosis, implant side, and duration of hearing loss were recorded.
Results: Changes in vestibular functioning became evident in the longitudinal data acquired from the participants. Declines in the vHIT gains occurred the most in the lateral semicircular. Increased unilateral weakness was chronicled in the caloric test. Both the oVEMP and cVEMP demonstrated decreased amplitudes and increased latencies. In functional testing, there was slight decline as measured by shorter Romberg stances and longer timed-up-and-go (TUG) test scores. In the aggregate, the data demonstrated that cochlear implantation alters the vestibular pathways, even if some of the participants did not have pronounced deficits.
Conclusion: The results indicate that clinically significant changes pertaining to balance occur in children and adults post cochlear implantation. Consequently, pertinent pre-operative counselling, monitoring post-operatively, and swift referrals for balance rehabilitation when appropriate, must be emphasized. Expanding upon this, further studies, particularly those pertaining to advanced follow-up duration, will enhance our understanding of vestibular decline predictors and advanced methodologies that preserve balance functionalities.
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