Subjective and objective vestibular changes that occur following paediatric cochlear implantation: systematic review and meta-analysis
Abstract Objective Cochlear implantation can result in post-operative vestibular dysfunction of unknown clinical significance. The objective of this study was to characterize the presence, magnitude, and clinical significance of vestibular dysfunction that occurs after pediatric cochlear implantatio...
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| Language: | English |
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SAGE Publishing
2019-05-01
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| Series: | Journal of Otolaryngology - Head and Neck Surgery |
| Online Access: | http://link.springer.com/article/10.1186/s40463-019-0341-z |
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| author | Michael Yong Emily Young Jane Lea Hannah Foggin Erica Zaia Frederick K. Kozak Brian D. Westerberg |
| author_facet | Michael Yong Emily Young Jane Lea Hannah Foggin Erica Zaia Frederick K. Kozak Brian D. Westerberg |
| author_sort | Michael Yong |
| collection | DOAJ |
| description | Abstract Objective Cochlear implantation can result in post-operative vestibular dysfunction of unknown clinical significance. The objective of this study was to characterize the presence, magnitude, and clinical significance of vestibular dysfunction that occurs after pediatric cochlear implantation. Data sources The databases Embase, Medline (OvidSP), and PubMed were used. Only articles published in English were included. Grey literature and unpublished sources were also reviewed. Study selection Articles published from 1980 until the present which documented pre-operative and post-operative vestibular testing on children under the age of 18 were used. Data extraction Parameters that were assessed included number of patients, pre- and post-operative vestibular-evoked myogenic potentials (VEMPs), head impulse testing (HIT), calorics, and posturography, timing of pre- and post-operative testing, symptomatology, and other demographic data such as etiology of the hearing loss. Data synthesis Ten articles were included. Relative risk values evaluating the effect of cochlear implantation on vestibular function were calculated for VEMPs and caloric testing due to the availability of published data. I2 values were calculated and 95% confidence intervals were reported. Separate analyses were conducted for each individual study and a pooled analysis was conducted to yield an overall relative risk. Assessment on risk of bias in individual studies and overall was performed. Conclusion Pediatric cochlear implantation is associated with a statistically significant decrease in VEMP responses post-operatively (RR 1.8, p < 0.001, I2 91.86, 95%CI 1.57–2.02). Similar results are not seen in caloric testing. Insufficient data is available for analysis of HIT and posturography. Further studies are necessary to determine the effect of cochlear implantation on objective vestibular measures post-operatively and whether any changes seen are clinically relevant in this population. |
| format | Article |
| id | doaj-art-440b7eb050ef47cfb769409fb673edd5 |
| institution | Kabale University |
| issn | 1916-0216 |
| language | English |
| publishDate | 2019-05-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Journal of Otolaryngology - Head and Neck Surgery |
| spelling | doaj-art-440b7eb050ef47cfb769409fb673edd52025-01-03T01:45:58ZengSAGE PublishingJournal of Otolaryngology - Head and Neck Surgery1916-02162019-05-0148111010.1186/s40463-019-0341-zSubjective and objective vestibular changes that occur following paediatric cochlear implantation: systematic review and meta-analysisMichael Yong0Emily Young1Jane Lea2Hannah Foggin3Erica Zaia4Frederick K. Kozak5Brian D. Westerberg6BC Rotary Hearing and Balance Centre, St. Paul’s HospitalBC Rotary Hearing and Balance Centre, St. Paul’s HospitalBC Rotary Hearing and Balance Centre, St. Paul’s HospitalBC Rotary Hearing and Balance Centre, St. Paul’s HospitalBC Rotary Hearing and Balance Centre, St. Paul’s HospitalBC Rotary Hearing and Balance Centre, St. Paul’s HospitalBC Rotary Hearing and Balance Centre, St. Paul’s HospitalAbstract Objective Cochlear implantation can result in post-operative vestibular dysfunction of unknown clinical significance. The objective of this study was to characterize the presence, magnitude, and clinical significance of vestibular dysfunction that occurs after pediatric cochlear implantation. Data sources The databases Embase, Medline (OvidSP), and PubMed were used. Only articles published in English were included. Grey literature and unpublished sources were also reviewed. Study selection Articles published from 1980 until the present which documented pre-operative and post-operative vestibular testing on children under the age of 18 were used. Data extraction Parameters that were assessed included number of patients, pre- and post-operative vestibular-evoked myogenic potentials (VEMPs), head impulse testing (HIT), calorics, and posturography, timing of pre- and post-operative testing, symptomatology, and other demographic data such as etiology of the hearing loss. Data synthesis Ten articles were included. Relative risk values evaluating the effect of cochlear implantation on vestibular function were calculated for VEMPs and caloric testing due to the availability of published data. I2 values were calculated and 95% confidence intervals were reported. Separate analyses were conducted for each individual study and a pooled analysis was conducted to yield an overall relative risk. Assessment on risk of bias in individual studies and overall was performed. Conclusion Pediatric cochlear implantation is associated with a statistically significant decrease in VEMP responses post-operatively (RR 1.8, p < 0.001, I2 91.86, 95%CI 1.57–2.02). Similar results are not seen in caloric testing. Insufficient data is available for analysis of HIT and posturography. Further studies are necessary to determine the effect of cochlear implantation on objective vestibular measures post-operatively and whether any changes seen are clinically relevant in this population.http://link.springer.com/article/10.1186/s40463-019-0341-z |
| spellingShingle | Michael Yong Emily Young Jane Lea Hannah Foggin Erica Zaia Frederick K. Kozak Brian D. Westerberg Subjective and objective vestibular changes that occur following paediatric cochlear implantation: systematic review and meta-analysis Journal of Otolaryngology - Head and Neck Surgery |
| title | Subjective and objective vestibular changes that occur following paediatric cochlear implantation: systematic review and meta-analysis |
| title_full | Subjective and objective vestibular changes that occur following paediatric cochlear implantation: systematic review and meta-analysis |
| title_fullStr | Subjective and objective vestibular changes that occur following paediatric cochlear implantation: systematic review and meta-analysis |
| title_full_unstemmed | Subjective and objective vestibular changes that occur following paediatric cochlear implantation: systematic review and meta-analysis |
| title_short | Subjective and objective vestibular changes that occur following paediatric cochlear implantation: systematic review and meta-analysis |
| title_sort | subjective and objective vestibular changes that occur following paediatric cochlear implantation systematic review and meta analysis |
| url | http://link.springer.com/article/10.1186/s40463-019-0341-z |
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