Which approach is better for the protection of vestibular receptors in cochlear implant surgery: Round window or standard cochleostomy?

Authors : Muhammed Dağkiran, Ülkü Tuncer, Özgür Sürmelioğlu, Özgür Tarkan, Süleyman Özdemir, Elvan Onan, Mete Kiroğlu

Pages : 187-195

View : 15 | Download : 5

Publication Date : 2019-12-10

Article Type : Research

Abstract :Objectives: This study aims to compare electrode insertion techniques in cochlear implantation CI as the standard cochleostomy approach SCA versus the round window approach RWA on five vestibular end-organ functions and vertigo in the pre- and postoperative period. Patients and Methods: In total, 51 patients 22 males, 29 females; mean age 38.2 years; range 16 to 70 years with normal vestibular function and operated with single-sided CI were included in this study between January 2015 and December 2019. Of the patients, 30 were operated with the RWA and 21 with the SCA. All of the patients were evaluated with the Dizziness Handicap Inventory DHI and a complete vestibular test battery including the video head impulse test vHIT , cervical vestibular-evoked myogenic potential cVEMP , and ocular vestibular-evoked myogenic potential oVEMP at one week preoperatively and one month postoperatively. Results: Patients in the RWA group had a statistically significantly better protected vestibular functions and fewer subjective vertigo symptoms in the postoperative period p<0.05 . Deterioration in at least one of the five vestibular end-organ functions was observed in eight of 21 patients 38.09% in the SCA group, compared to three of 30 10% in the RWA group. A significant correlation was detected between the vestibular tests and DHI in both groups r=0.686, p=0.001 in the SCA group and r=0.630, p<0.001 in the RWA group . Conclusion: Our study results suggest that RWA for CI may minimize damage to vestibular receptor functions and vertigo symptoms than SCA.
Keywords : Cervical vestibular-evoked myogenic potentials, dizziness handicap inventory, ocular vestibular-evoked myogenic potentials, vertigo, video head impulse test