
Mingwei Xu
Xinhua Hospital, Shanghai Jiaotong University School of Medicine, ChinaPresentation Title:
Vestibular Dysfunction in Paediatric Patients with Cochlear Implantation — A Systematic Review and Meta-Analysis
Abstract
Objective: Vestibular dysfunction may delay the
achievement of balance and perception milestones in paediatric patients after
Cochlear Implantation (CIM).
Methods: We searched the PubMed, Medline, Embase, Web
of Science, and Cochrane Library databases from inception to July 2022. Studies
involving subjective or objective vestibular function changes in children after
CIM were included. Two reviewers independently assessed the level of evidence,
methodological limitations, risk of bias, and characteristics of the cases.
Matched pre- and postoperative vestibular functional test data, including
ocular and cervical vestibular-evoked myogenic potential (oVEMP and cVEMP), caloric
test, video Head Impulse Test (vHIT), and Bruininks-Oseretsky Test 2 (BOT-2),
were used to calculate the relative risk of vestibular disorders. Subgroup
analyses were performed according to surgical approach and CIM device status.
Results: Twenty studies that met the inclusion criteria
were selected for the meta-analysis. We observed significant vestibular
dysfunction in paediatric patients with CIM. The results showed a statistically
significant increase in abnormal cVEMP response (RR = 2.20, 95%CI = 1.87, 2.58,
P < 0.0001), abnormal oVEMP response (RR = 2.10, 95%CI = 1.50,
2.94, P < 0.0001), and abnormal caloric test results (RR = 1.62, 95%CI =
1.20, 2.19, P = 0.0018) after implantation. Statistically significant
differences were not found in the vHIT test results of all three semicircular
canals before and after the operation (P > 0.05). Regarding static and
dynamic balance, we found significantly poorer BOT-2 scores in children with
CIM than in the normal group (mean difference = -7.26, 95% CI = -10.82, -3.70,
P < 0.0001).
Conclusions: The results showed that vestibular dysfunction
may occur after CIM in paediatric patients. Some children experience
difficulties in postural control and balance. Both VEMPs and caloric tests can
be performed after CIM. Our results suggest that the comprehensive evaluation
of vestibular function should be performed before and after CIM.
Biography
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