Loss of saccular function after cochlear implantation: The diagnostic impact of intracochlear electrically elicited vestibular evoked myogenic potentials
Loss of saccular function after cochlear implantation: The diagnostic impact of intracochlear electrically elicited vestibular evoked myogenic potentials
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DOI：
10.1159/000113509
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发表时间：
2008-01-01
影响因子：
1.6
通讯作者：
Ernst, A.
中科院分区：
文献类型：
--
作者：
Basta, D.;Todt, I.;Ernst, A.
耳蜗植入手术已成为聋人恢复听力的成功手术。然而，一些患者抱怨手术后持续头晕，这可能对他们的生活质量产生重大影响。对18例人工耳蜗植入者在术前、术后进行前庭神经系统检查。此外，术中诱发前庭诱发肌源性电位，以更详细地研究电刺激耳蜗植入电极（eVEMP）对球囊前庭感受器细胞的可能干扰。大多数患者人工耳蜗植入后，囊泡功能受损。然而，eVEMPs可以记录在所有患者术中通过颅内，高电平电刺激通过人工耳蜗植入电极。从本质上讲，人工耳蜗植入后的急性短期头晕似乎主要是由于各种原因造成的短暂前庭功能障碍。与此相反，人工耳蜗植入手术后的慢性持续性头晕主要是由于囊状黄斑功能障碍，而囊状黄斑是耳石系统的组成部分。这种囊状损害最有可能是由耳蜗植入电极推进到内耳时的插入创伤引起的。前庭下神经的电刺激可能共同激活可能在术后持续性头晕的发病机制中发挥额外的作用。版权所有（c）2008 S. Karger AG，巴塞尔。
Cochlear implant surgery has become a successful procedure for deaf patients to restore their hearing again. Some of the patients, however, complain of persisting dizziness after the surgery which can have a major impact on their quality of life. Neurotological tests of the vestibular system were applied in a total of 18 cochlear implantees pre-and postoperatively. In addition, vestibular evoked myogenic potentials were evoked intraoperatively to investigate possible interferences of the electrically stimulated cochlear implant electrode (eVEMP) with vestibular receptor cells of the saccule in more detail. After cochlear implantation, the saccular function was impaired in the majority of the patients. However, eVEMPs could be recorded intraoperatively in all patients by intracochlear, high-level electrical stimulation via the cochlear implant electrode. In essence, acute, short-term dizziness after cochlear implantation seems to result primarily from a transient vestibular deficit of various origins. In contrast to this, chronic, persisting dizziness after cochlear implant surgery is largely based on a dysfunction of the saccular macula which is an integral component of the otolith system. This saccular impairment is induced most likely by the insertion trauma of the cochlear implant electrode when advancing it into the inner ear. A possible coactivation of the inferior vestibular nerve by the electrical stimulation might play an additional role in the pathogenesis of the persisting postsurgical dizziness. Copyright (c) 2008 S. Karger AG, Basel.