Changes of Otolith and Balance Function Related to Cochlear Implant in Hearing Loss With Inner Ear Malformations Children

IF 1.7 4区 医学 Q2 OTORHINOLARYNGOLOGY Clinical Otolaryngology Pub Date : 2024-10-14 DOI:10.1111/coa.14236
Mengya Shen, Shujin Xue, Xingmei Wei, Biao Chen, Ying Kong, Yongxin Li
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Abstract

Objectives

The increase of bilateral cochlear implantation (CI) in recent years has made it essential to comprehend the effects of CI on otolith function. This study aimed to investigate the development of gross motor and otolith function in patients with inner ear malformations (IEMs) using vestibular-evoked myogenic potentials (VEMPs).

Materials and Methods

Overall, 78 patients with sensorineural hearing loss (SNHL) (age 5.7 ± 4.1 years) were divided into two groups based on the presence (IEM group, n = 39) or absence (control group, n = 39) of IEMs. VEMP testing was performed both before and 1–3 months after CI, and the evaluation of gross motor development was carried out.

Results

The mean ages for achieving head control and independent walking were delayed in the IEM group compared with the control group (p = 0.02). The preoperative cervical VEMP (cVEMP) and ocular VEMP (oVEMP) response rates were higher in the control group (60% and 86.95%) than in the IEM group (57.69% and 74.35%) (p < 0.05). Additionally, abnormal cVEMP was associated with delayed acquisition of independent walking (p = 0.017). Saccular and utricular functions after CI were lost by 40% and 31.75%, respectively, in patients who elicited preoperative VEMPs waveform (n = 25).

Conclusions

Among SNHL patients, balance development is more delayed in patients of IEMs than in patients without IEMs. The cVEMP and oVEMP waveforms differed greatly between the two groups. The otolith-vestibular nerve conduction pathway can be affected by CI, potentially leading to otolith function impairment. Therefore, it is essential to assess otolith and balance functions before CI, and this evaluation should be considered an integral part of clinical practice.

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听力损失伴内耳畸形儿童耳石和平衡功能与人工耳蜗植入的相关变化
目的:近年来,随着双侧人工耳蜗植入术(CI)的增加,有必要了解 CI 对耳石功能的影响。本研究旨在利用前庭诱发肌源性电位(VEMPs)调查内耳畸形(IEMs)患者的大运动和耳石功能发育情况:78名感音神经性听力损失(SNHL)患者(年龄为5.7 ± 4.1岁)根据是否存在内耳畸形分为两组(内耳畸形组,39人)。在CI前和CI后1-3个月进行VEMP测试,并对大运动发育情况进行评估:结果:与对照组相比,IEM 组实现头部控制和独立行走的平均年龄推迟了(P = 0.02)。对照组的术前颈部 VEMP(cVEMP)和眼部 VEMP(oVEMP)反应率(60% 和 86.95%)高于 IEM 组(57.69% 和 74.35%)(P 结论:在 SNHL 患者中,平衡能力的发展是一个复杂的过程:在 SNHL 患者中,IEM 患者的平衡能力发展比非 IEM 患者更迟缓。两组患者的 cVEMP 和 oVEMP 波形差异很大。耳石-前庭神经传导通路会受到 CI 的影响,从而可能导致耳石功能受损。因此,在进行 CI 前对耳石和平衡功能进行评估非常重要,而且这种评估应被视为临床实践中不可或缺的一部分。
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来源期刊
Clinical Otolaryngology
Clinical Otolaryngology 医学-耳鼻喉科学
CiteScore
4.00
自引率
4.80%
发文量
106
审稿时长
>12 weeks
期刊介绍: Clinical Otolaryngology is a bimonthly journal devoted to clinically-oriented research papers of the highest scientific standards dealing with: current otorhinolaryngological practice audiology, otology, balance, rhinology, larynx, voice and paediatric ORL head and neck oncology head and neck plastic and reconstructive surgery continuing medical education and ORL training The emphasis is on high quality new work in the clinical field and on fresh, original research. Each issue begins with an editorial expressing the personal opinions of an individual with a particular knowledge of a chosen subject. The main body of each issue is then devoted to original papers carrying important results for those working in the field. In addition, topical review articles are published discussing a particular subject in depth, including not only the opinions of the author but also any controversies surrounding the subject. • Negative/null results In order for research to advance, negative results, which often make a valuable contribution to the field, should be published. However, articles containing negative or null results are frequently not considered for publication or rejected by journals. We welcome papers of this kind, where appropriate and valid power calculations are included that give confidence that a negative result can be relied upon.
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