Minimally invasive surgical techniques in vestibular function preservation in patients with cochlear implants

被引:1
|
作者
Wang, Ruijie [1 ,2 ]
Luo, Jianfen [1 ,2 ]
Chao, Xiuhua [1 ,2 ]
Wang, Haibo [1 ]
Fan, Zhaomin [1 ]
Xu, Lei [1 ,2 ]
机构
[1] Shandong Univ, Shandong Prov ENT Hosp, Dept Otolaryngol Head & Neck Surg, Jinan, Peoples R China
[2] Shandong Prov ENT Hosp, Dept Auditory Implantat, Jinan, Peoples R China
基金
中国国家自然科学基金;
关键词
cochlear implantation; minimally invasive surgery; vestibular function; otolith; canal; HEARING PRESERVATION; FIBROSIS; CHILDREN; TRAUMA;
D O I
10.3389/fnins.2022.900879
中图分类号
Q189 [神经科学];
学科分类号
071006 ;
摘要
BackgroundCochlear implantation (CI) is an effective and successful method of treating individuals with severe-to-profound sensorineural hearing loss (SNHL). Coupled with it's great clinical effectiveness, there is a risk of vestibular damage. With recent advances in surgical approach, modified electrode arrays and other surgical techniques, the potential of hearing preservation (HP) has emerged, in order to preserve the inner ear function. These techniques may also lead to less vestibular damage. However, a systematic study on this at different follow-ups after CI surgery has not been documented before. AimsTo investigate changes of vestibular function systematically in recipients at short and long follow-ups after a minimally invasive CI surgery. MethodsIn this retrospective study, 72 patients (72 ears) with minimally invasive CI were recruited. All participants selected had bilateral SNHL and pre-operative residual hearing (RH) and underwent unilateral CI. They were treated to comprehensive care. All patients underwent vestibular function tests 5 days prior to CI. During the post-operative period, follow-up tests were performed at 1, 3, 6, 9, and 12 months. The contemporaneous results of caloric, cervical vestibular-evoked myogenic potential (cVEMP), ocular vestibular-evoked myogenic potential (oVEMP), and video head impulse (vHIT) tests were followed together longitudinally. ResultsOn the implanted side, the percent fail rate of caloric test was significantly higher than that of vHIT at 1, 3, and 9 months post-operatively (p < 0.05); the percent fail rate of oVEMP was higher than vHIT of superior semicircular canal (SSC), posterior semicircular canal (PSC), or horizontal semicircular canal (HSC) at 1, 3, and 9 months (p < 0.05); at 3 and 9 months, the percent fail rate of cVEMP was higher than that of SSC and PSC (p < 0.05). There were no significant differences in the percent fail rates among all tests at 6 and 12 months post-CI (p > 0.05). The percent fail rates showed decreased trends in caloric (p = 0.319) and HSC tested by vHIT (p = 0.328) from 1-3 to 6-12 months post-operatively. There was no significant difference in cVEMP between 1-3 and 6-12 months (p = 0.597). No significant differences on percent fail rates of cVEMP and oVEMP between short- and long-terms post-CI were found in the same subjects (p > 0.05). Before surgery, the abnormal cVEMP and oVEMP response rates were both lower in patients with enlarged vestibular aqueduct (EVA) than patients with a normal cochlea (p = 0.001, 0.018, respectively). ConclusionThe short- and long-term impacts on the vestibular function from minimally invasive CI surgery was explored. Most of the vestibular functions can be preserved with no damage discrepancy among the otolith and three semicircular canal functions at 12 months post-CI. Interestingly, a similar pattern of changes in vestibular function was found during the early and the later stages of recovery after surgery.
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页数:11
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