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Otorinolaringologia 2009 December;59(4):209-19


language: English

Cochlear implant-associated vestibular issues in children

Zhou G. 1, 2, Gopen Q. 1, 2

1 Department of Otolaryngology and Communication Enhancement, Children’s Hospital Boston, Boston, MA, USA 2 Department of Otology and Laryngology, Harvard Medical School, Boston, MA, USA


Cochlear implantation has become a standard procedure to restore hearing for children with severe to profound sensorineural hearing loss who can not benefit from conventional amplification. Previously published studies have demonstrated the effectiveness of cochlear implant in facilitating the acquirement and/or improvement in speech/language development as well as communication skills, particularly in young children with prelingual, congenital or early onset hearing loss. Consequently, the criteria for cochlear implant candidacy in children have been expanded considerably over the years. Recently, a new trend of bilateral cochlear implantation has gained popularity world-wide while debates on its validity and feasibility are still ongoing. Regardless its justification, performance or cost, cochlear implantation, as a surgical procedure, bears certain medical concern, e.g., effects on vestibular function. This concern may become more urgent and serious since younger children, less than one year of age, may be considered for bilateral cochlear implants. The purpose of this review is to provide clinicians and researchers with a comprehensive update on cochlear implant-associated vestibular issues which have been investigated in recent years, particularly in the pediatric population. Subjects addressed by this contemporary review are: 1) evidences of negative impacts of cochlear implant on peripheral vestibular function, 2) possible mechanisms involved in cochlear implant’s effect on vestibular function, 3) importance of vestibular evaluation for children who are cochlear implant candidates. Possible solutions to minimize the damages to vestibular function by cochlear implant are also discussed with aim to encourage future studies.

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