Does the surgical approach in cochlear implantation influence the occurrence of postoperative vertigo?
OBJECTIVE
To investigate the impact of different cochleostomy techniques on vestibular receptor integrity and vertigo after cochlear implantation.


METHODS
Retrospective cohort study.


METHODS
A total of 62 patients (17 to 84 years of age) underwent implantation via an anterior or round window insertion approach.


METHODS
Two groups of cochlear implant patients were compared with respect to their pre- and postoperative vestibular function and the occurrence of postoperative vertigo. The data were related to the different cochleostomy techniques. The patients were tested by a questionnaire (dizziness handicap inventory, DIH), caloric irrigation (vestibulo-ocular reflex, VOR) for the function of the lateral SCC and by vestibular evoked myogenic potential (VEMP) recordings for saccular function.


RESULTS
Significant differences of postoperative VEMP responses (50% vs 13%) and electromystagmography (ENG) results (42.9% vs 9.4%) were found with respect to the 2 different insertion techniques. The number of patients with vertigo after the surgery as evidenced by DHI (23% vs 12.5%) was significantly different.


CONCLUSIONS
The used round window approach for electrode insertion should be preferred to decrease the risk of loss of vestibular function and the occurrence of vertigo.
Todt
Ingo
I
Department of Otolaryngology at UKB, Hospital of the University of Berlin (Charité Medical School), Berlin, Germany. Ingo.Todt@ukb.de
Basta
Dietmar
D
Ernst
Arne
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019929:Cochlear Implantation / Q000009:adverse effects* / Q000379:methods*; D004584:Electronystagmography; D005073:Evoked Potentials, Somatosensory; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D014717:Vertigo / Q000145:classification / Q000175:diagnosis / Q000209:etiology*