Impact of cochlear implantation on the function of the three semicircular canals

Int J Audiol. 2020 Nov;59(11):843-849. doi: 10.1080/14992027.2020.1768310. Epub 2020 Jul 9.

Abstract

Objective: To assess the effect of cochlear implantation on the function of the semicircular canals (SCC) and on experienced vestibular symptoms. Second, to determine the relation between vestibular test results.

Design: Retrospective cohort study assessing absolute and categorised results of caloric irrigation test, video Head Impulse Test (vHIT) and Dizziness Handicap Inventory (DHI) before and after cochlear implantation.Study sample: 192 patients, aged ≥7 years old, without preoperative areflexia.

Results: Mean maximum slow phase velocity decreased with 3.1°/s and 4.7°/s for warm and cold caloric irrigation respectively. About 37.4% of the patients deteriorated one or more categories on caloric testing. Complete caloric postoperative areflexia was found in 6.2%. Mean vHIT gain decreased with 0.06, 0.04 and 0.05 for anterior, lateral and posterior SCC, respectively. Seven patients (7.7%) acquired an abnormal gain value for the anterior SCC. Only mean score on DHI's physical subdomain rose significantly (1.4 points). Overall, 9.0% of the patients deteriorated one or two categories on DHI. Only few weak correlations were found between caloric test, vHIT and DHI shifts.

Conclusions: Although mean objective and subjective-physical vestibular deteriorations were significant, its clinical impact seems limited. However, 9% of patients experience vestibular deterioration, thus, advocate assessment. Vestibular test results show no or merely weak mutual correlations.

Keywords: Cochlear implantation; Dizziness Handicap Inventory; caloric test; vestibular function tests; vestibulo-ocular-reflex; video Head Impulse Test.

MeSH terms

  • Caloric Tests
  • Cochlear Implantation*
  • Head Impulse Test
  • Humans
  • Reflex, Vestibulo-Ocular
  • Retrospective Studies
  • Semicircular Canals