内耳畸形患儿人工耳蜗植入前后前庭诱发肌源性电位变化
Preoperative and Postoperative Vestibular Evoked Myogenic Potentials Changes in Cochlear Implant Children with Inner Ear Malformation
薛书锦;魏兴梅;沈梦雅;陆思萌;杨梦戈;孔颖;李永新
1:首都医科大学附属北京同仁医院耳鼻咽喉科
2:耳鼻咽喉头颈科学教育部重点实验室(首都医科大学)
3:北京市耳鼻咽喉科研究所
摘要[Abstract] Objective Vestibular evoked myogenic potential (VEMP) was tested in children with inner ear malformation before and after cochlear implantation to study the change of VEMP elicitation before and after cochlear implantation and its relationship with the occurrence of postoperative vestibular symptoms. Methods From January to June, 2021, a total of 29 children were enrolled and diagnosed with congenital severe sensorineural hearing loss in our center. There were 17 cases (34 ears) with inner ear malformation, including 4 cases with enlarged vestibular aqueduct,7 cases with Mondini malformations，6 cases with common cavity and 12 cases (24 ears) without inner ear malformation. Cervical vestibular evoked myogenic potential (cVEMP) and ocular vestibular evoked myogenic potential (oVEMP) tests were performed on the children 1 day before and 1 month after surgery. Within 1 week after the operation, the symptoms and signs of vestibular dysfunction were observed, examined and recorded. Results The cVEMP/oVEMP elicitation rate was 73.68%(14/19)/88.89%(8/9)，100%(7/7)/100%(7/7)，85. 71%(12/14)/100%(10/10)，22.22%(2/9)/0(0/7) in the group without inner ear malformation, the group with enlarged vestibular aqueduct, Mondini malformation and the group with common cavity deformity, respectively. The elicitation rate at 1 month after operation was 50%(6/12)/45.45%(5/11)，and VEMP damge rate was 88.89% (8/9).Conclusion VEMP can be applied to evaluate vestibular function before and after cochlear implantation in children. Inner ear malformation is an important factor influencing the VEMP elicitation rate, and the VEMP results can provide effective reference for the selection of cochlear implant side and the symptoms of postoperative vestibular injury.
关键词基金项目(Foundation):作者参考文献1 West N,Klokker M,Cayé-Thomasen P.Vestibular screening before cochlear implantation:clinical implications and challenges in 409 cochlear implant recipients[J].Otology & Neurotology,2021,42(2):e137-e144.
2 Jacot E,Abbeele T,Debre HR,et al.Vestibular impairments pre- and post-cochlear implant in children—science direct[J].International Journal of Pediatric Otorhinolaryngology,2009,73( 2):209-217.
3 Hansen S,Anthonsen K,Stangerup SE,et al.Unexpected findings and surgical complications in 505 consecutive cochlear implantations:a proposal for reporting consensus[J].Acta-Otolaryngologica,2010,130(5):540-549.
4 Nisenbaum E,Prentiss S,Yan D,et al.Screening strategies for deafness genes and functional outcomes in cochlear implant patients[J].Otology & Neurotology,2021,42(1):180-187.
5 Carlyon RP,Goehring T.Cochlear implant research and development in the twenty-first century:a critical update[J].Journal of the Association for Research in Otolaryngology,2021,21:481-508.
6 West N,Tian L,Petersen L,et al.Objective vestibular ttest battery and patient reported outcomes in cochlear implant recipients[J].Otology & Neurotology,2021,42(4):e416-e424.
7 Wei X,Li Y,Fu QJ,et al.Slotted labyrinthotomy approach with customized electrode for patients with common cavity deformity[J].Laryngoscope,2018,128(2):468-472.
8 Fife TD,Colebatch JG,Kerber KA,et al.Practice guideline:cervical and ocular vestibular evoked myogenic potential testing:report of the guideline development,dissemination,and implementation subcommittee of the American academy of neurology[J].Neurology,2017,89(22):2288-2296.
9 Jin Y,Nakamura M,Shinjo Y,et al.Vestibular-evoked myogenic potentials in cochlear implant children[J].Acta Otolaryngol,2006,126(2):164-169.
10 Dhondt C,Maes L,Vanaudenaerde S,et al.Changes in vestibular function following pediatric cochlear implantation:a prospective study [J].Ear Hearing,2022,43(2):620-630.
11 Sosna-Duranowska M,Tacikowska G,Gos E,et al.Vestibular function after cochlear implantation in partial deafness treatment[J].Frontiers in Neurology,2021,12.https://DOI.org/10.3389/fneur.2021.667055.
12 Li H,Schart-Moren N,Rajan G,et al.Vestibular organ and cochlear implantation—a synchrotron and micro-CT study[J].Frontiers in Neurology,2021,12.https://DOI.org/10.3389/fneur.2021.663722.
13 Wang R,Zhang D,Luo J,et al.Influence of cochlear implantation on vestibular function in children with an enlarged vestibular aqueduct[J].Frontiers in Neurology,2021,12.https://DOI.org/10.3389/fneur.2021.663123.