Case report: Can cochlear implant stimulation lead to improved balance even after vestibular neurectomy?

Morgana Sluydts, Chloë De Laet, Liesbeth De Coninck, Catherine Blaivie, Joost J S van Dinther, Erwin Offeciers, Floris L Wuyts, Andrzej Zarowski
Author Information
  1. Morgana Sluydts: Ear-Nose-Throat Department, European Institute for Otorhinolaryngology, Head and Neck Surgery, Antwerp, Belgium.
  2. Chloë De Laet: Lab for Equilibrium Investigations and Aerospace, Faculty of Sciences, University of Antwerp, Antwerp, Belgium.
  3. Liesbeth De Coninck: Ear-Nose-Throat Department, European Institute for Otorhinolaryngology, Head and Neck Surgery, Antwerp, Belgium.
  4. Catherine Blaivie: Ear-Nose-Throat Department, European Institute for Otorhinolaryngology, Head and Neck Surgery, Antwerp, Belgium.
  5. Joost J S van Dinther: Ear-Nose-Throat Department, European Institute for Otorhinolaryngology, Head and Neck Surgery, Antwerp, Belgium.
  6. Erwin Offeciers: Ear-Nose-Throat Department, European Institute for Otorhinolaryngology, Head and Neck Surgery, Antwerp, Belgium.
  7. Floris L Wuyts: Ear-Nose-Throat Department, European Institute for Otorhinolaryngology, Head and Neck Surgery, Antwerp, Belgium.
  8. Andrzej Zarowski: Ear-Nose-Throat Department, European Institute for Otorhinolaryngology, Head and Neck Surgery, Antwerp, Belgium.

Abstract

Introduction: In a previous manuscript from our research group, the concept of vestibular co-stimulation was investigated in adult subjects who received a cochlear implant (CI). Despite what literature reports state, no signs of vestibular co-stimulation could be observed.
Results: In this case report, it was described how a woman, who previously underwent a neurectomy of the left vestibular nerve and suffers from bilateral vestibulopathy (BVP), reported improved balance whenever her CI on the left was stimulating. Unexpectedly, the sway analyses during posturography indeed showed a clinically relevant improvement when the CI was activated.
Discussion: Vestibular co-stimulation as a side effect of CI stimulation could not be the explanation in this case due to the ipsilateral vestibular neurectomy. It is more likely that the results can be attributed to the electrically restored auditory input, which serves as an external reference for maintaining balance and spatial orientation. In addition, this patient experienced disturbing tinnitus whenever her CI was deactivated. It is thus plausible that the tinnitus increased her cognitive load, which was already increased because of the BVP, leading to an increased imbalance in the absence of CI stimulation.

Keywords

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Word Cloud

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