title: Long-term follow-up of late onset vestibular complaints in patients with cochlear implant.
abstract: CONCLUSIONS
  Patients with cochlear implants should be treated no differently than non-implanted patients with similar symptomatology.
  
  
  OBJECTIVE
  To describe the spectrum of symptomatology, treatment, and long-term follow-up of patients with cochlear implant and vestibular complaints.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
authors.affiliation: a 1 Subdivision of Otolaryngology Head and Neck Surgery, Instituto Nacional de Rehabilitacion , Distrito Federal, Mexico.
authors.forename: Mauricio
authors.initials: M
authors.lastname: González-Navarro
authors.affiliation: b 2 Department of Otorhinolaryngology, Clínica Universidad de Navarra , Pamplona, Spain.
authors.forename: Raquel
authors.initials: R
authors.lastname: Manrique-Huarte
authors.affiliation: b 2 Department of Otorhinolaryngology, Clínica Universidad de Navarra , Pamplona, Spain.
authors.forename: Manuel
authors.initials: M
authors.lastname: Manrique-Rodríguez
authors.affiliation: b 2 Department of Otorhinolaryngology, Clínica Universidad de Navarra , Pamplona, Spain.
authors.forename: Alicia
authors.initials: A
authors.lastname: Huarte-Irujo
authors.affiliation: b 2 Department of Otorhinolaryngology, Clínica Universidad de Navarra , Pamplona, Spain.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Pérez-Fernández
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001301:Audiometry, Pure-Tone; D002648:Child; D003054:Cochlear Implants / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D034381:Hearing Loss / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011379:Prognosis; D012189:Retrospective Studies; D013997:Time Factors; D014717:Vertigo / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D014722:Vestibule, Labyrinth / Q000503:physiopathology*; D055815:Young Adult
keywords: Cochlear implant; hearing loss; instability; vertigo; vestibular symptoms