| Objective: To analyze the effects of CI on vestibular function in children with severe to profound sensorineural deafness by observing the vestibular characteristics of children with bilateral sensorineural deafness,and to compare the characteristics of vestibular function in children with unilateral CI,different inner ear morphology and postoperative rehabilitation time.The results of this study were used to provide a more comprehensive assessment of the vestibular function of children with severe sensorineural deafness and to provide an objective basis for developing vestibular rehabilitation training for children with vestibular dysfunction.Methods: A total of 242 children diagnosed with bilateral severe to profound sensorineural deafness and receiving CI in Department of Otorhinolaryngology,Lanzhou University Second Hospital and 17 healthy control children from 2012 to2022 were selected for vestibular function examination.27 of them completed VEMP examination and BERG balance scale test before and 1 month after surgery,96 UCIs and 119 BCIs.Postoperative children completed vestibular function examinations at different postoperative times.By comparing the VEMP changes before and after CI surgery,different inner ear morphology,unilateral and bilateral CI implantation and different postoperative recovery time vestibular function characteristics,the correlation between VEMP elicitation and BERG balance scale test and VEMP in children with bilateral sensorineural deafness and children with normal hearing was explored;the effects of unilateral and bilateral cochlear implantation,different inner ear structures and postoperative recovery time on CI The effects of single and bilateral cochlear implants,different inner ear structures and postoperative recovery time on the vestibular function of children after surgery were analyzed;17age-matched children with normal hearing were selected as the control group.The results were statistically analyzed using SPSS25.0 software.Result:1.The c VEMP elicitation rate was lower in children with bilateral severe to profound sensorineural deafness compared with children of the same age group with normal hearing,with no significant differences in any of the parameters.o VEMP elicitation rate was not significantly different,and N1-P1 amplitude was higher than that of children of the same age group with normal hearing.2.In the 27 children with CI who completed preoperative and 1-month postoperative c VEMP examinations,the c VEMP elicitation rate decreased from78.79% to 24.24% and the o VEMP elicitation rate decreased from 56.52% to 21.74%at 1 month postoperatively.The P1 wave latency of c VEMP and N1 wave latency of o VEMP were both prolonged in the 1-month postoperative group compared with the preoperative period.3.To analyze the characteristics of vestibular function in children with different inner ear morphology after CI surgery,c VEMP examination was performed in 119 children who had recovered for >1 year after BCI surgery,and the results showed that there was no significant difference in the c VEMP elicitation rate between the children with no inner ear deformity and the children with EVA(p>0.05),and the children in the EVA group had longer N1 latency,P1-N1 interwave period and higher amplitude;80 children with BCI surgery who had recovered for >1 year were examined for o VEMP.The results showed that there was a significant difference in the rate of o VEMP elicitation between children with no inner ear deformity and those with EVA(p < 0.05),and the rate of o VEMP elicitation was higher in the EVA group,and the N1 latency,P1 latency,N1-P1 interwave interval were longer and the amplitude was higher in the EVA group.4.Comparing the vestibular function of 96 children with UCI and 119 children with BCI who completed c VEMP examination,the results showed that there was a significant difference in the c VEMP elicitation rate between children with BCI and children with UCI(p=0.001),and the c VEMP elicitation rate was higher in children with BCI than with UCI,and there was no significant difference in each parameter(p>0.05);for children with UCI who completed o VEMP The results of postoperative o VEMP in 55 children with UCI and 69 children with BCI who completed the examination were compared: there was a significant difference in the rate of o VEMP elicitation between children with BCI and children with UCI(p=0.030),and the rate of o VEMP elicitation was higher in children with BCI than with UCI,with no significant difference in each parameter(p>0.05).5.When comparing 96 postoperative children with UCI who completed c VEMP and 80 postoperative children with UCI who completed o VEMP,there was no significant difference in the c VEMP and o VEMP elicitation rates between the postoperative rehabilitation duration ≤ 1 year group and the postoperative rehabilitation duration >1 year group(p=0.097,p=0.152),and there was also no significant difference in all parameters of c VEMP and o VEMP between the two groups(p >0.05).6.To investigate the changes of VEMP on the non-operative side after CI,the results of VEMP on the non-operative side were compared in 96 children with UCI after completion of c VEMP examination and 80 children with completion of o VEMP examination: there was no significant difference in the elicitation rate of VEMP on the non-operative side between the postoperative rehabilitation duration ≤ 1 year group and the postoperative rehabilitation duration >1 year(p > 0.05),and there were significant differences in the N1 latency of c VEMP,P1-N1 wave There were significant differences in the N1 latency and P1-N1 wave interval of c VEMP(p=0.007,p=0.003),and longer N1 latency and P1-N1 wave interval in the postoperative rehabilitation length >1 year group.o VEMP parameters were not significantly different(p>0.05).Conclusions:1.VEMP elicitation rates are highly positively correlated with BERG balance scale scores,and c VEMP elicitation rates are lower in children with bilateral severe to very severe sensorineural deafness than in children with normal hearing.2.CI surgery has varying degrees of damage to the peripheral vestibular organs,with a more pronounced effect on the balloon than on the elliptical capsule.3.The amplitude of VEMP was higher in children with EVA than in the group with normal inner ear structures,and the latency and interwave periods of each wave were longer.4.Higher rate of postoperative VEMP elicitation in children with long-term BCI compared to UCI5.CI surgery had no significant effect on the rate of VEMP elicitation on the non-operative side. |
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