Vestibular and taste disorders after bilateral cochlear implantation
Vestibular and taste disorders after bilateral cochlear implantation
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DOI：
10.1007/s00405-010-1320-1
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发表时间：
2010-12-01
影响因子：
2.6
通讯作者：
Todt, Ingo
中科院分区：
文献类型：
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作者：
Wagner, Jan H.;Basta, Dietmar;Todt, Ingo
本研究的目的是调查双侧人工耳蜗植入术后前庭感受器缺陷和味觉障碍的发生率，并找出这些并发症的风险是否更高的第二次植入。在一项回顾性队列研究中，我们检查了20名患者（11-58岁，平均年龄41.5岁），这些患者在2000年至2007年间顺序植入（人工耳蜗植入之间的平均时间为32.9 +/- A 25个月）。通过主观评定[头晕障碍量表（DHI）]、热量灌注[前庭眼反射（VOR）]和前庭诱发肌源性电位（VEMP）记录球囊功能进行术前和术后前庭测试。术前和术后通过问卷调查和测试（舌头两侧的酸/甜/苦/咸）评价味觉。DHI评价显示，第一次植入后平均增加2.7 +/- A 7.7 SD点，中度不显著，第二次植入后平均增加9.4 +/- A 16.6 SD点。同侧VEMP反应在第一次手术后3耳（27.3%）和第二次手术后2耳（18.2%）消失。VOR仅在首次植入后消失1次（5.9%）。1例（5%）患者在单侧植入后和3例（15%）双侧植入后的问卷中抱怨持续味觉障碍。具体测试显示，在一个案件（5%）单侧味觉障碍后，同侧人工耳蜗植入。我们的数据显示，第二次植入后主观眩晕的风险更高。双侧人工耳蜗植入前的风险咨询应包括单侧和/或双侧前庭功能障碍的发生以及味觉障碍的潜在风险，以增加患者在决策过程中的法医学安全性。
The objective of this study was to investigate the occurrence of vestibular receptor deficiency and taste disorders after bilateral cochlear implantation in postlingually deafened patients and to find out whether the risk for these complications is higher for the second implantation. In a retrospective cohort study, we examined 20 patients (11-58 years, mean age 41.5 years), implanted sequentially between 2000 and 2007 (mean period between cochlear implantation 32.9 +/- A 25 months). Pre- and postoperative vestibular testing was performed by subjective rating [Dizziness Handicap Inventory (DHI)], caloric irrigation [vestibuloocular reflex (VOR)] and by vestibular-evoked myogenic potential (VEMP) recordings for saccular function. The sense of taste was evaluated pre- and postoperatively by a questionnaire and testing (sour/sweet/bitter/salty bilaterally on the tongue). DHI evaluation showed a moderate not significant mean increase by 2.7 +/- A 7.7 SD points after the first and a significant increase by 9.4 +/- A 16.6 SD points after the second implantation. Ipsilateral VEMP responses disappeared in three ears (27.3%) after the first and in two ears (18.2%) after the second operation. VOR disappeared only once (5.9%) after the first implantation. One (5%) patient complained of a persisting disturbance of taste in the questionnaire after unilateral and 3 (15%) after bilateral implantation. Specific testing showed in one case (5%) a unilateral taste disorder after ipsilateral cochlear implantation. Our data show that there is a higher risk for subjective vertigo after the second implantation. The occurrence of unilateral and/or bilateral vestibular dysfunction and the potential risk of taste disorder should be included in the risk counseling before bilateral cochlear implantation to increase patients' and medicolegal safety in the decision-making process.