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

BACKGROUND: Cochlear 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 el...

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Autores principales: Wang, Ruijie, Luo, Jianfen, Chao, Xiuhua, Wang, Haibo, Fan, Zhaomin, Xu, Lei
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9551174/
https://www.ncbi.nlm.nih.gov/pubmed/36238083
http://dx.doi.org/10.3389/fnins.2022.900879
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author Wang, Ruijie
Luo, Jianfen
Chao, Xiuhua
Wang, Haibo
Fan, Zhaomin
Xu, Lei
author_facet Wang, Ruijie
Luo, Jianfen
Chao, Xiuhua
Wang, Haibo
Fan, Zhaomin
Xu, Lei
author_sort Wang, Ruijie
collection PubMed
description BACKGROUND: Cochlear 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. AIMS: To investigate changes of vestibular function systematically in recipients at short and long follow-ups after a minimally invasive CI surgery. METHODS: In 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. RESULTS: On 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). CONCLUSION: The 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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spelling pubmed-95511742022-10-12 Minimally invasive surgical techniques in vestibular function preservation in patients with cochlear implants Wang, Ruijie Luo, Jianfen Chao, Xiuhua Wang, Haibo Fan, Zhaomin Xu, Lei Front Neurosci Neuroscience BACKGROUND: Cochlear 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. AIMS: To investigate changes of vestibular function systematically in recipients at short and long follow-ups after a minimally invasive CI surgery. METHODS: In 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. RESULTS: On 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). CONCLUSION: The 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. Frontiers Media S.A. 2022-09-27 /pmc/articles/PMC9551174/ /pubmed/36238083 http://dx.doi.org/10.3389/fnins.2022.900879 Text en Copyright © 2022 Wang, Luo, Chao, Wang, Fan and Xu. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Neuroscience
Wang, Ruijie
Luo, Jianfen
Chao, Xiuhua
Wang, Haibo
Fan, Zhaomin
Xu, Lei
Minimally invasive surgical techniques in vestibular function preservation in patients with cochlear implants
title Minimally invasive surgical techniques in vestibular function preservation in patients with cochlear implants
title_full Minimally invasive surgical techniques in vestibular function preservation in patients with cochlear implants
title_fullStr Minimally invasive surgical techniques in vestibular function preservation in patients with cochlear implants
title_full_unstemmed Minimally invasive surgical techniques in vestibular function preservation in patients with cochlear implants
title_short Minimally invasive surgical techniques in vestibular function preservation in patients with cochlear implants
title_sort minimally invasive surgical techniques in vestibular function preservation in patients with cochlear implants
topic Neuroscience
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9551174/
https://www.ncbi.nlm.nih.gov/pubmed/36238083
http://dx.doi.org/10.3389/fnins.2022.900879
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