Cochlear Implantation in Meniere's Disease: A Systematic Review and Meta-Analysis
The Laryngoscope
Villavisanis, D. F., Mavrommatis, M. A., et al. (2021).
The Laryngoscope, 131(8), 1845-1854.
This systematic review and meta-analysis investigates the effects of cochlear implantation, with or without labyrinthectomy, on speech perception, vertigo, tinnitus, and quality of life in individuals with Meniere's disease.
Not stated
From database inception to August 14, 2019
Excludes review articles, articles concerning basic science, or articles not available as full-text; Included study designs not further specified
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For individuals with Meniere's disease (MD), cochlear implantation (CI), with or without labryrinthectomy, demonstrated positive post-operative outcomes (i.e., speech perception, vertigo, tinnitus). Meta-analysis of thirty studies found that speech perception improved significantly with a mean difference of 44.7 (95% CI=8.8-80.6) on the Hearing in Noise Testing (HINT) at 6-months post-CI and 60.1 (95% CI=35.3-85.0) at 12-months post-CI. This review also reported improved quality of life post-CI for individuals with MD. The authors note that additional research is warranted, particularly for the effects of CI and labyrinthectomy on vertigo.
Nineteen studies investigating the effect of cochlear implantation (CI) on vertigo in individuals with Meniere's disease found that the majority of studies used subjective self-reporting. One study reported quantitative outcomes as measured by the Dizziness Handicap Inventory [53.2 point improvement (95% CI=27.2-79.3)]. One study reported vestibular evoked myogenic potentials (VEMPs) with a 15% increased vibratory ocular VEMP and a 25% increased cervical VEMP. The authors found that "vertigo generally improved through objective (DHI) and subjective measures, even in those patients who did not undergo concurrent labyrinthectomy" (p. 7). The authors note that additional research on the effects of CI and labyrinthectomy on vertigo is warranted.
Meta-analysis of two studies reporting Tinnitus Handicap Inventory (THI) data for individuals with Meniere's disease found a statistically significant decrease in tinnitus symptoms [48.1 point reduction (95% CI=1.0-95.2)] after cochlear implantation, with or without labrynthectomy.
