A longitudinal study on the impact of cochlear implantation on vestibular function in children with inner ear malformations:a comparative analysis based on the test of vestibular evoked myogenic potentials
Objective To analyze the impact of cochlear implantation(CI)on vestibular evoked myogenic potentials(VEMPs)in children with congenital sensorineural hearing loss(SNHL),focusing on the potential changes in vestibular function after surgery.Methods A total of 78 pediatric patients with SNHL,who were treated at Beijing Tongren Hospital,Capital Medical University between January 2021 and February 2023,were enrolled.The cohort was divided into two groups based on inner ear anomalies:39 SNHL patients with normal inner ear structure and 39 patients with inner ear malformations,including 6 patients with large vestibular aqueduct syndrome,13 patients with Mondini malformation,5 patients with vestibulocochlear nerve deficiency,2 patients with vestibular sac malformation,and 2 with narrow internal auditory canal.All patients underwent VEMPs test was performed preoperatively(T0)within one week,and at 1 month(T1),6 months(T2),and 1 year(T3)post-CI.Chi-square tests and analysis of variance were applied to compare the differences in VEMPs parameters,including response rate,latencies,and amplitude,across all follow-up time and between the two groups.Results Complete postoperative follow-up of cervical VEMP(cVEMP)was achieved in all 78 patients,The T0 cVEMP response rate was 69.23％,which significantly declined to 46.15％,41.03％,and 58.97％at T1,T2,and T3,respectively(x2=4.768,P=0.003).Notably,the P1 and N1 latencies significantly shortened at T1(P=0.07,P=0.046).Among 48 patients who completed postoperative ocular VEMP(oVEMP)follow-up,the overall preoperative response rate was 75％,increasing to 81.25％at T1 but decreasing to 62.5％at both T2 and T3.The overall oVEMP response rate also showed a statistically significant difference pre-and post-CI(x2=9.720,P=0.021).The duration of CI significantly influenced cVEMP-P1 latency,amplitude,and rectified amplitude(P=0.043 4,P=0.041,P=0.041,P＜0.001),as well as oVEMP amplitude(P=0.043).No significant differences were observed in cVEMP response rates,latencies,or amplitudes at T3 compared to T0.However,oVEMP amplitudes at T2 and T3 were significantly different from T0(P=0.038).No significant differences were observed in VEMP parameters between the inner ear malformation and non-malformation groups across T1-T3.Conclusions VEMPs serve as a valuable tool for assessing vestibular function before and after CI in children with SNHL.The duration of CI is a crucial factor influencing VEMPs changes.Inner ear malformations may impact otolithic function post-CI,with a more pronounced effect observed over time.The VEMP test results could provide insights for selecting the optimal side for CI placement.
cochlear implantationinner ear malformationpediatric patientsvestibular function assessmentvestibular evoked myogenic potentials
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维普
