Long-term follow-up of late onset vestibular complaints in patients with cochlear implant

• Published in: Acta oto-laryngologica Vol. 135; no. 12; pp. 1245 - 1252
• Main Authors: González-Navarro, Mauricio, Manrique-Huarte, Raquel, Manrique-Rodríguez, Manuel, Huarte-Irujo, Alicia, Pérez-Fernández, Nicolas
• Format: Journal Article
• Language: English
• Published: England Informa Healthcare 02-12-2015
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Audiometry, Pure-Tone; Child; Cochlear implant; Cochlear Implants - adverse effects; Female; Follow-Up Studies; hearing loss; Hearing Loss - diagnosis; Hearing Loss - physiopathology; Hearing Loss - surgery; Humans; instability; Male; Middle Aged; Postoperative Complications; Prognosis; Retrospective Studies; Time Factors; vertigo; Vertigo - diagnosis; Vertigo - etiology; Vertigo - physiopathology; vestibular symptoms; Vestibule, Labyrinth - physiopathology; Young Adult; Cochlear implant; hearing loss; vertigo; vestibular symptoms; instability
• ISSN: 0001-6489; 1651-2251
• DOI: 10.3109/00016489.2015.1072874

Conclusion: Patients with cochlear implants should be treated no differently than non-implanted patients with similar symptomatology. Objectives: To describe the spectrum of symptomatology, treatment, and long-term follow-up of patients with cochlear implant and vestibular complaints. Methods: This retrospective study included 25 patients with late onset vestibular complaints (more than 1 month post-implantation). Each patient underwent an extensive interrogatory and physical exam with ancillary test to complete a diagnosis. Treatment was given according to this and all patients followed a vestibular rehabilitation program. Results: The total population was 72% male and 28% female, median age was 58 years; minimal follow-up was 9 months (mean = 51, median = 34). Cochleostomy was performed in eight cases and round window insertion was performed in 19 (two patients were removed from each group in the analysis due to their bilateral implantation under a different approach). The mean time from implant to vestibular symptoms was 53 months, median = 32; a Kaplan Meier graphic showed the round window approach has faster onset of symptoms with statistical significance (p = 0.020). The most common complaint was instability in all patients and after both surgical approaches. No difference in symptoms was found with a Kruskall Wallis test except for vertigo spells (more common in the round window approach). In 12 patients the symptomatology was attributed to the implanted side. In the long-term follow-up a relatively high number of patients (20/25) recovered with standard treatment, suggesting the presence of the implant is not associated with poor recovery prognosis.