title: Cochlear implantation in patients with Meniere's disease.
abstract: OBJECTIVE
  Few studies have addressed the benefits of cochlear implantation for the small group of patients with bilateral, end-stage Meniere's disease, or unilateral disease with contralateral hearing loss from another cause. Our retrospective study evaluates the effectiveness and post-operative performance in these Meniere's disease patients and discusses these findings relative to other post-lingually deafened adults.
  
  
  METHODS
  Among 456 adults who received cochlear implants, we identified eight (1.7%) patients with Meniere's disease who met clinical indications for implantation and a control group of seven non-Meniere's patients of comparable age and deafness. Data gathered included demographics, auditory and vestibular symptoms pre-implantation, and clinical course after implantation, including audiometric scores (consonant-nucleus-consonant (CNC), hearing-in-noise testing (HINT), and AzBio score) and audiologic evaluations.
  
  
  RESULTS
  Comparing the Meniere's and non-Meniere's patients, pre- to post-implant scores averaged 15 and 16%-57 and 76% for CNC; and 4.5 and 40.5%-78 and 81% for AzBio and/or HINT tests, respectively; scores between groups did not statistically differ. Of note, five of eight patients had 0% word recognition scores pre-operatively. Fluctuations in CI performance were seen in five patients with Meniere's disease but not for those without the disease.
  
  
  CONCLUSIONS
  Audiologic testing found a strong likelihood that CIs did benefit our subset of Meniere's patients with severe to profound sensorineural hearing loss. Fluctuations in hearing sensitivity (perhaps owing to physical changes relative to the implant array with the spiral ganglion neurons during an acute attack or changes in spiral ganglion neurons because of the hydropic state) can often be resolved by subsequent reprogramming.
authors.forename: Ravi N
authors.initials: RN
authors.lastname: Samy
authors.forename: Lisa
authors.initials: L
authors.lastname: Houston
authors.forename: Michael
authors.initials: M
authors.lastname: Scott
authors.forename: Daniel I
authors.initials: DI
authors.lastname: Choo
authors.forename: Jareen
authors.initials: J
authors.lastname: Meinzen-Derr
mesh_terms: D000328:Adult; D000368:Aged; D001302:Audiometry, Speech / Q000379:methods / Q000706:statistics & numerical data*; D016022:Case-Control Studies; D019929:Cochlear Implantation / Q000706:statistics & numerical data*; D005260:Female; D006319:Hearing Loss, Sensorineural / Q000209:etiology / Q000601:surgery*; D006801:Humans; D008297:Male; D008575:Meniere Disease / Q000150:complications*; D008875:Middle Aged; D009622:Noise; D011184:Postoperative Period; D012189:Retrospective Studies; D013067:Speech Perception / Q000502:physiology; D013136:Spiral Ganglion; D016896:Treatment Outcome
keywords: Cochlear implant; Hearing; Meniere's disease; Outcomes; Sensorineural hearing loss