title: Preoperative vestibular assessment protocol of cochlear implant surgery: an analytical descriptive study.
abstract: BACKGROUND
  Cochlear implants are undeniably an effective method for the recovery of hearing function in patients with hearing loss.
  
  
  OBJECTIVE
  To describe the preoperative vestibular assessment protocol in subjects who will be submitted to cochlear implants.
  
  
  METHODS
  Our institutional protocol provides the vestibular diagnosis through six simple tests: Romberg and Fukuda tests, assessment for spontaneous nystagmus, Head Impulse Test, evaluation for Head Shaking Nystagmus and caloric test.
  
  
  RESULTS
  21 patients were evaluated with a mean age of 42.75±14.38 years. Only 28% of the sample had all normal test results. The presence of asymmetric vestibular information was documented through the caloric test in 32% of the sample and spontaneous nystagmus was an important clue for the diagnosis. Bilateral vestibular areflexia was present in four subjects, unilateral arreflexia in three and bilateral hyporeflexia in two. The Head Impulse Test was a significant indicator for the diagnosis of areflexia in the tested ear (p=0.0001). The sensitized Romberg test using a foam pad was able to diagnose severe vestibular function impairment (p=0.003).
  
  
  CONCLUSIONS
  The six clinical tests were able to identify the presence or absence of vestibular function and function asymmetry between the ears of the same individual.
authors: Universidade de São Paulo (USP), Escola de Medicina, Departamento de Otorrinolaringologia, São Paulo, SP, Brazil.
authors: Roseli Saraiva Moreira
authors: RSM
authors: Bittar
authors: Universidade de São Paulo (USP), Escola de Medicina, Departamento de Otorrinolaringologia, São Paulo, SP, Brazil. Electronic address: esetsuo@icloud.com.
authors: Eduardo Setsuo
authors: ES
authors: Sato
authors: Universidade de São Paulo (USP), Escola de Medicina, Departamento de Otorrinolaringologia, São Paulo, SP, Brazil.
authors: Douglas Jósimo Silva
authors: DJS
authors: Ribeiro
authors: Universidade de São Paulo (USP), Escola de Medicina, Departamento de Otorrinolaringologia, São Paulo, SP, Brazil.
authors: Robinson Koji
authors: RK
authors: Tsuji
mesh_terms: D000328:Adult; D019929:Cochlear Implantation; D003054:Cochlear Implants; D003430:Cross-Sectional Studies; D003638:Deafness / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015837:Vestibular Diseases / Q000175:diagnosis / Q000601:surgery*; D014724:Vestibular Function Tests / Q000145:classification
keywords: Cochlear implant; Diagnóstico pré-operatório; Função vestibular; Implante coclear; Preoperative diagnosis; Vestibular function