Does the surgical approach in cochlear implantation influence the occurrence of postoperative vertigo?

Otolaryngol Head Neck Surg. 2008 Jan;138(1):8-12. doi: 10.1016/j.otohns.2007.09.003.

Abstract

Objective: To investigate the impact of different cochleostomy techniques on vestibular receptor integrity and vertigo after cochlear implantation.

Study design: Retrospective cohort study.

Subjects: A total of 62 patients (17 to 84 years of age) underwent implantation via an anterior or round window insertion approach.

Methods: Two groups of cochlear implant patients were compared with respect to their pre- and postoperative vestibular function and the occurrence of postoperative vertigo. The data were related to the different cochleostomy techniques. The patients were tested by a questionnaire (dizziness handicap inventory, DIH), caloric irrigation (vestibulo-ocular reflex, VOR) for the function of the lateral SCC and by vestibular evoked myogenic potential (VEMP) recordings for saccular function.

Results: Significant differences of postoperative VEMP responses (50% vs 13%) and electromystagmography (ENG) results (42.9% vs 9.4%) were found with respect to the 2 different insertion techniques. The number of patients with vertigo after the surgery as evidenced by DHI (23% vs 12.5%) was significantly different.

Conclusion: The used round window approach for electrode insertion should be preferred to decrease the risk of loss of vestibular function and the occurrence of vertigo.

Publication types

  • Clinical Trial
  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Cochlear Implantation / adverse effects*
  • Cochlear Implantation / methods*
  • Electronystagmography
  • Evoked Potentials, Somatosensory
  • Follow-Up Studies
  • Humans
  • Middle Aged
  • Postoperative Complications*
  • Retrospective Studies
  • Surveys and Questionnaires
  • Vertigo / classification
  • Vertigo / diagnosis
  • Vertigo / etiology*