Long-term follow-up of late onset vestibular complaints in patients with cochlear implant
González-Navarro M (1), Manrique-Huarte R (2), Manrique-Rodríguez M (2), Huarte-Irujo A (2), Pérez-Fernández N (2).
(1) Subdivision of Otolaryngology Head and Neck Surgery, Instituto Nacional de Rehabilitacion , Distrito Federal, Mexico.
(2) Department of Otorhinolaryngology, Clínica Universidad de Navarra , Pamplona, Spain.
Patients with cochlear implants should be treated no differently than non-implanted patients with similar symptomatology.
To describe the spectrum of symptomatology, treatment, and long-term follow-up of patients with cochlear implant and vestibular complaints.
This retrospective study included 25 patients with late onset vestibular complaints (more than 1 month post-implantation). Each patient underwent an extensive interrogatory and physical exam with ancillary test to complete a diagnosis. Treatment was given according to this and all patients followed a vestibular rehabilitation program.
The total population was 72% male and 28% female, median age was 58 years; minimal follow-up was 9 months (mean = 51, median = 34).
Cochleostomy was performed in eight cases and round window insertion was performed in 19 (two patients were removed from each group in the analysis due to their bilateral implantation under a different approach).
The mean time from implant to vestibular symptoms was 53 months, median = 32; a Kaplan Meier graphic showed the round window approach has faster onset of symptoms with statistical significance (p = 0.020). The most common complaint was instability in all patients and after both surgical approaches. No difference in symptoms was found with a Kruskall Wallis test except for vertigo spells (more common in the round window approach). In 12 patients the symptomatology was attributed to the implanted side.
In the long-term follow-up a relatively high number of patients (20/25) recovered with standard treatment, suggesting the presence of the implant is not associated with poor recovery prognosis.
CITATION Acta Otolaryngol. 2015 Dec;135(12):1245-52. doi: 10.3109/00016489.2015.1072874. Epub 2015 Jul 29.