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Impaired fixation suppression is a risk factor for vertigo after cochlear implantation

Published online by Cambridge University Press:  08 March 2017

E Krause ,
J Wechtenbruch ,
T Rader ,
A Berghaus  and
R Gürkov
E Krause*
Affiliation:
Department of Oto-rhino-laryngology, Head and Neck Surgery, Ludwig Maximilians University Munich, Germany
J Wechtenbruch
Affiliation:
Department of Oto-rhino-laryngology, Head and Neck Surgery, Ludwig Maximilians University Munich, Germany
T Rader
Affiliation:
Department of Oto-rhino-laryngology, Head and Neck Surgery, Johann Wolfgang Goethe University Frankfurt, Germany
A Berghaus
Affiliation:
Department of Oto-rhino-laryngology, Head and Neck Surgery, Ludwig Maximilians University Munich, Germany
R Gürkov
Affiliation:
Department of Oto-rhino-laryngology, Head and Neck Surgery, Ludwig Maximilians University Munich, Germany
*
Address for correspondence: Dr Eike Krause, Department of Oto-rhino-laryngology, Head and Neck Surgery, Ludwig Maximilians University Grosshadern, Marchioninistrasse 15, 81377 Munich, Germany. Fax: +49 89 70956869 E-mail: Eike.Krause@med.uni-muenchen.de
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Abstract

Objectives:

To analyse the correlation between visual fixation suppression test results and the occurrence of post-operative vertigo in patients receiving a cochlear implant, and to compare this with other possible risk factors.

Methods:

In a prospective study setting, caloric vestibular responses, visual fixation suppression and subjective vertigo symptoms were assessed in 59 adult patients undergoing cochlear implantation. These parameters were compared in patients with post-operative vertigo versus vertigo-free patients.

Results:

Vertigo symptoms were reported by 49 per cent of patients. Thirty-nine per cent of the patients had a decrease in caloric response on the implanted side. There was no statistically significant difference between the two patient groups regarding canal paresis, age, sex, implanted electrode type, implant side, surgeon, cause of deafness, petrous bone computed tomography findings and incidence of pre-operative vertigo. Patients with post-operative vertigo had a significantly greater prevalence of insufficient visual fixation suppression. All patients who suffered long-term post-operative vertigo had insufficient visual fixation suppression.

Conclusions:

Pre-operative impaired visual fixation suppression is a major risk factor for the occurrence of vertigo after cochlear implantation.

Keywords

Cochlear ImplantsVestibular Function TestsVertigo

Information

Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 123 , Issue 8 , August 2009 , pp. 845 - 850
Copyright
Copyright © JLO (1984) Limited 2009

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References

1 Fayad, JN, Linthicum, FH Jr. Multichannel cochlear implants: relation of histopathology to performance. Laryngoscope 2006;116:1310–20CrossRefGoogle ScholarPubMed
2 Handzel, O, Burgess, BJ, Nadol, JB Jr. Histopathology of the peripheral vestibular system after cochlear implantation in the human. Otol Neurotol 2006;27:57–64CrossRefGoogle ScholarPubMed
3 Tien, HC, Linthicum, FH Jr. Histopathologic changes in the vestibule after cochlear implantation. Otolaryngol Head Neck Surg 2002;127:260–4CrossRefGoogle ScholarPubMed
4 Todt, I, Basta, D, Ernst, A. Does the surgical approach in cochlear implantation influence the occurrence of postoperative vertigo? Otolaryngol Head Neck Surg 2008;138:8–12CrossRefGoogle ScholarPubMed
5 Enticott, JC, Tari, S, Koh, SM, Dowell, RC, O'Leary, SJ. Cochlear implant and vestibular function. Otol Neurotol 2006;27:824–30CrossRefGoogle ScholarPubMed
6 Steenerson, RL, Cronin, GW, Gary, LB. Vertigo after cochlear implantation. Otol Neurotol 2001;22:842–3CrossRefGoogle ScholarPubMed
7 Vibert, D, Häusler, R, Kompis, M, Vischer, M. Vestibular function in patients with cochlear implantation. Acta Otolaryngol Suppl 2001;545:29–34CrossRefGoogle ScholarPubMed
8 Buchman, CA, Joy, J, Hodges, A, Telischi, FF, Balkany, TJ. Vestibular effects of cochlear implantation. Laryngoscope 2004;114:1–22CrossRefGoogle ScholarPubMed
9 Brandt, T, Bartenstein, P, Janek, A, Dieterich, M. Reciprocal inhibitory visual-vestibular interaction. Visual motion stimulation deactivates the parieto-insular vestibular cortex. Brain 1998;121:1749–58CrossRefGoogle ScholarPubMed
10 Jahn, K, Strupp, M, Krafczyk, S, Schüler, O, Glasauer, S, Brandt, T. Suppression of eye movements improves balance. Brain 2002;125:2005–11CrossRefGoogle ScholarPubMed
11 Krause, E, Louza, JPR, Hempel, JM, Wechtenbruch, J, Rader, T, Gürkov, R. Prevalence and characteristics of preoperative balance disorders in cochlear implant candidates. Ann Otol Rhinol Laryngol 2008 Oct;117(10):764–8CrossRefGoogle ScholarPubMed
12 Hallpike, CS. The caloric tests. J Laryngol Otol 1956;70:15–28CrossRefGoogle ScholarPubMed
13 Brey, RH, Facer, GW, Trine, MB, Lynn, SG, Peterson, AM, Suman, VJ. Vestibular effects associated with implantation of a multiple channel cochlear prosthesis. Am J Otol 1995;16:424–30Google ScholarPubMed
14 Filipo, R, Patrizi, M, La Gamma, R, D'Elia, C, La Rosa, G, Barbara, M. Vestibular impairment and cochlear implantation. Acta Otolaryngol 2006;126:1266–74CrossRefGoogle ScholarPubMed
15 Ito, J. Influence of the multichannel cochlear implant on vestibular function. Otolaryngol Head Neck Surg 1998;118:900–2CrossRefGoogle ScholarPubMed
16 Klenzner, T, Neumann, M, Aschendorff, A, Laszig, R. Caloric stimulation of the vestibular organ after cochlear implant surgery [in German]. Laryngorhinootologie 2004;83:659–64CrossRefGoogle ScholarPubMed
17 Kubo, T, Yamamoto, K, Iwaki, T, Doi, K, Tamura, M. Different forms of dizziness occurring after cochlear implant. Eur Arch Otorhinolaryngol 2001;258:9–12CrossRefGoogle ScholarPubMed
18 Jin, Y, Nakamura, M, Shinjo, Y, Kaga, K. Vestibular-evoked myogenic potentials in cochlear implant children. Acta Otolaryngol 2006;126:164–9CrossRefGoogle ScholarPubMed
19 Mangham, CA. Effects of cochlear prostheses on vestibulo-ocular reflexes to rotation. Ann Otol Rhinol Laryngol Suppl 1987;128:101–4CrossRefGoogle Scholar
20 Fina, M, Skinner, M, Goebel, JA, Piccirillo, JF, Neely, JG, Black, O. Vestibular dysfunction after cochlear implantation. Otol Neurotol 2003;24:234–42CrossRefGoogle ScholarPubMed
21 Di Girolamo, S, Fetoni, AR, Di Nardo, W, Paludetti, G. An unusual complication of cochlear implant: benign paroxysmal positional vertigo. J Laryngol Otol 1999;113:922–3CrossRefGoogle ScholarPubMed
22 Graham, SS, Dickins, JR. Postimplantation Meniere's syndrome with fluctuant electrical thresholds. Ann Otol Rhinol Laryngol Suppl 1995;166:412–14Google ScholarPubMed
23 Bance, ML, O'Driscoll, M, Giles, E, Ramsden, RT. Vestibular stimulation by multichannel cochlear implants. Laryngoscope 1998;108:291–4CrossRefGoogle ScholarPubMed
24 Baloh, RW, Honrubia, V, Yee, RD, Hess, K. Changes in the human vestibulo-ocular reflex after loss of peripheral sensitivity. Ann Neurol 1984;16:222–8CrossRefGoogle ScholarPubMed
25 Brandt, T. Management of vestibular disorders. J Neurol 2000;247:491–9CrossRefGoogle ScholarPubMed
26 Straka, H, Dieringer, N. Basic organization principles of the VOR: lessons from frogs. Prog Neurobiol 2004;73:259–309CrossRefGoogle ScholarPubMed
27 Bense, S, Deutschländer, A, Stephan, T, Bartenstein, P, Schwaiger, M, Brandt, T et al. Preserved visual-vestibular interaction in patients with bilateral vestibular failure. Neurology 2004;63:122–8CrossRefGoogle ScholarPubMed
28 Kato, I, Kimura, Y, Aoyagi, M, Mizukoshi, K, Kawasaki, T. Visual suppression of caloric nystagmus in normal individuals. Acta Otolaryngol 1977;83:245–51CrossRefGoogle ScholarPubMed
29 Hillier, S, Hollohan, V. Vestibular rehabilitation for unilateral peripheral vestibular dysfunction. Cochrane Database Syst Rev 2007, Issue 4:CD005397 (doi: 10.1002/14651858)CrossRefGoogle ScholarPubMed
30 Schuchman, G, Uri, N. The variability of fixation suppression of caloric-induced nystagmus. J Laryngol Otol 1986;100:765–8CrossRefGoogle ScholarPubMed