Abstract
In children with profound deafness, bilateral cochlear implant (CI) is an effective, established procedure. However, its safety on vestibular function has recently been debated. The goal of this study is to evaluate the long-term lateral semicircular canal high-frequency vestibulo-oculomotor reflex (LSC HF VOR) in children with CI by video head impulse testing (vHIT). This is a cross-sectional study assessing a cohort of children who received either a unilateral (12) or a bilateral (12) cochlear implant (CI), compared with a control group of 12 normal-hearing children. No significant LSC HF VOR gain difference was found between CI users and controls. In the unilaterally implanted group, the LSC HF VOR gain measured in the “CI-ON” condition was significantly higher than in the “CI-OFF” condition, both in the implanted and in the non-implanted ear. In the bilaterally implanted group, the difference between the two conditions was not significant. Our results do not show any impairment of LSC HF VOR function in children with CI compared to normal-hearing children in the long-term period. This suggests that both unilateral and simultaneous/sequential bilateral CI are procedures that do not impair HF LSC long-term function when analyzed by vHIT.
Highlights
Bilateral cochlear implant (CI) has become the recommended indication for childhood deafness thanks to the growing attention to the importance of binaural hearing
We reported that in implanted children a significant impairment of lateral semicircular canal (LSC) function compared to normal hearing children was not observed [7]
When hearing-impaired children who are candidates for cochlear implantation have been studied for vestibular function, it has been shown that abnormal otolith responses and LSC dysfunction including areflexia with caloric testing vary between 50% to 68% [1,3,10], with no correlation with vestibular malformations or hearing loss etiology [1]
Summary
Bilateral cochlear implant (CI) has become the recommended indication for childhood deafness thanks to the growing attention to the importance of binaural hearing. Some papers analyzing the impact of unilateral cochlear implantation in children report abnormal results from vestibular assessment in 50% to 68% of cases [1,2,3]. It could be debatable if these abnormal results are clinically relevant or, on the other hand, if the clinical effect could be underestimated. The long-term function of vestibular labyrinth after cochlear implantation in children has not been extensively investigated in the literature. Video head impulse testing (vHIT) is a method for quantitative measurement of eye movements during head thrust testing and has been gaining popularity in the last years
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