The influence of electrode array design, scalar dislocation and insertion technique on postoperative vertigo in CI surgery - a prospective study.

IF 1.9 3区 医学 Q2 OTORHINOLARYNGOLOGY European Archives of Oto-Rhino-Laryngology Pub Date : 2024-12-12 DOI:10.1007/s00405-024-09147-1
Manuel Christoph Ketterer, A K Rauch, R L Beck, T F Jakob, L Fries, A Aschendorff, S Arndt, F Everad
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Abstract

Objectives: This study aimed to examine the effect of electrode array design, insertion angle, scalar position, and insertion technique on the occurrence of postoperative subjective vertigo following cochlear implant (CI) surgery using questionnaires in conjunction with objective vestibular functional measurements.

Materials and methods: We prospectively evaluated subjective vertigo using the Dizziness Handicap Inventory (DHI). Additionally, we performed videonystagmography, video head-impulse tests, and vestibular-evoked myogenic potentials to assess the objective vestibular function preoperatively, at four weeks and 12 months after CI. These results were compared with those of postoperative imaging using digital volume tomography.

Results: Postoperative vertigo was observed in 2 out of 62 patients (3%). Cochleostomy (n = 8) did not lead to an increase in postoperative vertigo. Functional diagnostics revealed abnormalities in up to 23% of patients without subjective dizziness. In our patient cohort, neither electrode array dislocation nor increasing insertion depth was associated with an increase in postoperative vertigo.

Conclusion: Both postoperative vertigo occurrence and electrode array dislocation rates have significantly decreased due to the optimized atraumatic electrode array design and improved surgical insertion techniques. Neither dislocation nor cochleostomy appeared to induce vertigo but the sample size was too small to draw definitive conclusions.

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研究目的本研究旨在通过问卷调查和客观前庭功能测量,研究电极阵列设计、插入角度、标尺位置和插入技术对人工耳蜗(CI)手术后主观眩晕发生率的影响:我们使用头晕障碍量表(DHI)对主观眩晕进行了前瞻性评估。此外,我们还进行了视频震颤成像、视频头脉冲测试和前庭诱发电位,以评估术前、CI 术后 4 周和 12 个月的客观前庭功能。这些结果与术后数字容积断层扫描成像的结果进行了比较:结果:62 例患者中有 2 例(3%)出现术后眩晕。耳蜗造口术(8 例)并未导致术后眩晕的增加。功能诊断显示,多达 23% 的患者存在异常,但无主观眩晕。在我们的患者群中,电极阵列脱位或插入深度增加都与术后眩晕的增加无关:结论:由于优化了无创伤电极阵列设计和改进了手术插入技术,术后眩晕发生率和电极阵列脱位率均显著下降。脱位和耳蜗植入术似乎都不会诱发眩晕,但由于样本量太小,无法得出明确结论。
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来源期刊
CiteScore
5.30
自引率
7.70%
发文量
537
审稿时长
2-4 weeks
期刊介绍: Official Journal of European Union of Medical Specialists – ORL Section and Board Official Journal of Confederation of European Oto-Rhino-Laryngology Head and Neck Surgery "European Archives of Oto-Rhino-Laryngology" publishes original clinical reports and clinically relevant experimental studies, as well as short communications presenting new results of special interest. With peer review by a respected international editorial board and prompt English-language publication, the journal provides rapid dissemination of information by authors from around the world. This particular feature makes it the journal of choice for readers who want to be informed about the continuing state of the art concerning basic sciences and the diagnosis and management of diseases of the head and neck on an international level. European Archives of Oto-Rhino-Laryngology was founded in 1864 as "Archiv für Ohrenheilkunde" by A. von Tröltsch, A. Politzer and H. Schwartze.
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