Cochlear Implants and Vestibular Anomalies
Cushing et al (2013) reported on 153 children with profound sensorinerual hearing loss (SNHL), 119 of whom had unilateral cochlear implants (CI) at the time of testing. Cushing and colleagues reported vestibular end-organ dysfunction was present in half of the subjects, and of note, none of the children reported signs or symptoms of vestibular injury after receiving their CI.
Beck et al and Cushing (2015) reported that vestibular disorders are highly associated with sensorineural hearing loss in children. However, children may not have the vocabulary, history, or concepts to describe vestibular anomalies. Beck and colleagues estimated vestibular and balance disorders may occur in some 15 percent of all children and may be present in up to 70 percent of children with SNHL.
Kuang et al (2015) published a systematic review of the evidence-based literature from 1980 to 2014, which included data from caloric stimulation of the horizontal canal in CI patients. The authors note measurement of caloric function is a non-standardized protocol and interpretations vary across centers. They report vertigo, dizziness, and/or imbalance often occur following CI surgery and these symptoms generally subside shortly thereafter. Kuang et al report the literature states 37 percent of patients experiences slow-phase-velocity (SPV) decreases and some 34 percent of patients experienced an onset pf caloric asymmetry post-cochlear implantation. The authors report gender, side of implant, and etiology of hearing loss were not predictive factors as to caloric results or symptoms. They state “all CI candidates should be advised of the variety of possible effects CI can have on labyrinth function….”
For More Information, References, and Recommendations
Beck D, Petrak M, Madell J, Cushing S. (2015) Update 2015: Pediatric Vestibular, Balance, and Hearing Disorders. Hearing Review January.
Cushing CL, Gordon KA, Rutka JA, James AL, Papsin BC. (2013) Vestibular End-Organ Dysfunction in Children with Sensorineural Hearing Loss and Cochlear Implants – An Expanded Cohort and Etiologic Assessment. Otology & Neurotology 34:422-428.
Kuang H, Haversat HH, Michaelides AM. (2015) Impairment of Caloric Function After Cochlear Implantation. Journal of Speech, Language, and Hearing Research 58(8):1387-1395.
Nandi R, Luxon LM. (2008) Development and Assessment of the Vestibular System. International Journal of Audiology 47:566-577.
Valente LM. (2007) Adaptation of adult techniques for evaluating vestibular function in children. Hearing Journal 60(10):33-44.
Wolter NE, Gordon KA, Papsin BC, Cushing SL. (2015) Vestibular and Balance Impairment Contributes to Cochlear Implant Failure on Children. Otology & Neurotology 36:1029–1034.