Labyrinth dysfunction 8 months after cochlear implantation: a case report.
OBJECTIVE
Investigate whether the cochleostomy is a possible port of entry for pneumolabyrinth and a resulting vertigo in patients provided with a cochlear implant.


METHODS
Retrospective case review.


METHODS
Ludwig-Maximilians University of Munich, Hospital Grosshadern.


METHODS
62-year-old patient who underwent implantation of a HiFocus II cochlear implant with positioner from Advanced Bionics (CLARION). Eight months postoperatively, the patient reported rotatory vertigo and right-side tinnitus after he had blown his nose harder than usual during an episode of rhinitis.


METHODS
Preoperative and postoperative testing of both the petrosal bone with a CT scan and of balance function.


METHODS
Air inclusion in the labyrinth.


RESULTS
In contrast to the preoperative high resolution computed tomography (CT) scan, air inclusion was seen in the labyrinth during the episode of vertigo. At the same time, balance function tests with Frenzel glasses revealed both spontaneous and provoked horizontal nystagmus to the right side. At follow-up 8 weeks later, the level of vertigo had significantly decreased. Twelve months later, the control CT showed the cochlear implant positioned correctly and no visible air in the labyrinth.


CONCLUSIONS
It is known that placement of the HiFocus II with Positioner from CLARION requires a relatively large cochleostomy of 1.5 mm. Moreover, in the connective tissue seal between the electrode and the positioner, the latter reaches into the tympanic cavity, and this is possibly the weak point. Further investigation will be needed to determine whether the large cochleostomy with the HiFocus II with positioner increases the predisposition to labyrinth dysfunction.
Hempel
John-Martin
JM
Ear Nose and Throat Clinic, Ludwig Maximilians University, Munich, Germany. John-Martin.Hempel@med.uni-muenchen.de
Jäger
Lorenz
L
Baumann
Uwe
U
Krause
Eike
E
Rasp
Gerd
G
D019929:Cochlear Implantation / Q000009:adverse effects*; D034381:Hearing Loss / Q000534:rehabilitation; D006801:Humans; D007759:Labyrinth Diseases / Q000209:etiology*; D008875:Middle Aged; D009759:Nystagmus, Pathologic / Q000209:etiology; D012189:Retrospective Studies; D012220:Rhinitis / Q000150:complications; D012307:Risk Factors; D014012:Tinnitus / Q000209:etiology; D014057:Tomography, X-Ray Computed; D014717:Vertigo / Q000209:etiology*