Incidence and quality of vertigo symptoms after cochlear implantation

[Redazione di acufeni.net]

Krause E, Louza JP, Wechtenbruch J, Hempel JM, Rader T, Gürkov R.

Department of Oto-rhino-laryngology, Head and Neck Surgery, Ludwig Maximilians University, Munich.

Objectives:To assess the incidence of vestibular disturbance in patients after cochlear implantation, and to evaluate the quality of vertigo symptoms.

Study design:Prospective, observational study.Setting:Cochlear implant centre at a tertiary referral university hospital, Munich, Germany.

Patients:Forty-seven adult patients undergoing unilateral cochlear implantation between 2003 and 2007.Methods:Patients were interviewed post-operatively about vertigo symptoms, using a specifically designed questionnaire. Questionnaire data were used to define patient subgroups based on probable vertigo aetiology. Cochlear implantation was performed via a retroauricular, transmastoidal approach. Thirty-six implants were Cochlear Nucleus 24 devices and 11 were MedEl devices.

Results:Twenty-one (45 per cent) patients reported vertigo symptoms following cochlear implantation. The time of onset was directly post-operatively in the majority of patients. In 90 per cent, the symptoms suggested an otogenic origin. The majority of patients reported paroxysmal vertigo with a duration of seconds to minutes. Typical concomitant symptoms were tinnitus, fluctuating hearing loss and vegetative reactions. Serious disablement by vertigo was rare.

Conclusion:Exposing patients to the risk of possible balance disorders associated with cochlear implantation is justified in view of the hearing rehabilitation achieved, even with today's broader indications for cochlear implantation. However, patients should in any case be informed about the possibility and quality of post-operative vertigo symptoms.