Preoperative vestibular assessment to predict hearing outcome after CI implantation.

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Hearing impairment is the most common sensorineural deficit, affecting one out of three adults above the age of 65. When hearing aids are no longer sufficing, cochlear implantation is the standard treatment to restore hearing ability. Multiple studies have reported vestibular involvement after CI implantation, leading to complications such as vertigo and postural instability. In addition, postoperative vestibular dysfunction is associated with worsened hearing recovery. Because of this relationship, and the close anatomical proximity and phylogenetic similarity of the cochlea and vestibulum, preoperative vestibular function may be a predictive factor for postoperative hearing outcome. In this study, we tested the hypothesis that preoperative vestibular dysfunction (measured via VEMP, vHIT and caloric testing) predicts postoperative hearing outcome in the form of speech intelligibility. In 113 adults who underwent CI implantation, pre- and postoperative vestibular and auditory data has been collected. We observed that preoperative vestibular function positively correlated with postoperative speech intelligibility (p=0.007), having poorer speech outcome in case of vestibular dysfunction. As such, preoperative vestibular testing could ensure better patient counseling and decision making concerning cochlear implantation, providing more personalized and effective care.
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