Hearing performance as a predictor of postural recovery in cochlear implant users☆

Greters, Mario Edvin; Bittar, Roseli Saraiva Moreira; Grasel, Signe Schuster; Oiticica, Jeanne; Bento, Ricardo Ferreira

doi:10.1016/j.bjorl.2016.01.002

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Brazilian Journal of Otorhinolaryngology

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Original articles • Braz. j. otorhinolaryngol. 83 (1) • Jan-Feb 2017 • https://doi.org/10.1016/j.bjorl.2016.01.002 copy

Hearing performance as a predictor of postural recovery in cochlear implant users^☆ ☆ Please cite this article as: Greters ME, Bittar RS, Grasel SS, Oiticica J, Bento RF. Hearing performance as a predictor of postural recovery in cochlear implant users. Braz J Otorhinolaryngol. 2017;83:16-22.

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective

This study aimed to evaluate if hearing performance is a predictor of postural control in cochlear implant (CI) users at least six months after surgery.

Methods

Cross-sectional study including (CI) recipients with post-lingual deafness and controls who were divided into the following groups: nine CI users with good hearing performance (G+), five CI users with poor hearing performance (G−), and seven controls (CG). For each patient, computerized dynamic posturography (CDP) tests, a sensory organization test (SOT), and an adaptation test (ADT) were applied as dual task performance, with first test (FT) and re-test (RT) on the same day, including a 40–60 min interval between them to evaluate the short-term learning ability on postural recovery strategies. The results of the groups were compared.

Results

Comparing the dual task performance on CDP and the weighted average between all test conditions, the G+ group showed better performance on RT in SOT4, SOT5, SOT6, and CS, which was not observed for G− and CG. The G− group had significantly lower levels of short-term learning ability than the other two groups in SOT5 (p = 0.021), SOT6 (p = 0.025), and CS (p = 0.031).

Conclusion

The CI users with good hearing performance had a higher index of postural recovery when compared to CI users with poor hearing performance.

Keywords
Dizziness; Balance; Hearing loss; Posturography; Auditory evoked potentials; Cochlear implant

	G- (n = 5)	G+ (n = 9)
Female gender, n (%)	2 (40%)	5 (56%)
Median age (min–max)	57 (34–66)	38 (23–57)
Duration of hearing loss (years): median (min–max)	18.8 (1–36)	12.8 (1–43)
Cochlear implant activation (months): median (min–max)	20.33 (5–55)	25 (9–37)
Nucleus 22 processing strategy: speak	3	2
Nucleus 24 processing strategy: ACE	2	7
Deafness etiology
Meningitis	5	0
Trauma	0	1
Otosclerosis	0	2
Ototoxicity	0	1
Chronic otitis media	0	1
Unknown	0	4

Groups		G+	G-	CG	Kruskal–Wallis test (p)	Tukey's multiple comparisons (p)
Open-set sentences	Median (min–max)	100 (80–100)	0 (0–20)	100 (100–100)	0.004^a a Statistical significance level.	G+ = CG > G- (<0.001)
Monosylabic vocal discrimination	Median (min–max)	84 (58–100)	0 (0–88)	100 (96–100)	0.001^a a Statistical significance level.	G+ = CG > G- (<0.001)
n		9	5	7

Groups		G+	G-	CG	Kruskal–Wallis test (p)	Tukey's multiple comparisons (p)
SOT1 FT	Median (min–max)	94.3 (91.3–95.7)	93 (92–97.7)	96 (92.3–97)	0.172	G+ = G- = CG
SOT2 FT	Median (min–max)	92.7 (86.7–94.3)	90 (88–96)	94.7 (90–97.7)	0.088	G+ = G- = CG
SOT3 FT	Median (min–max)	91 (79.7–95.3)	90 (82.7–91.3)	94 (93.3–97)	0.018^a a Statistical significance level.	G+ = G- < CG (0.036^b b CG showed significant higher scores as compared to G+ and G- in SOT3, SOT4, SOT5, SOT6, and CES conditions. )
SOT4 FT	Median (min–max)	68.7 (55.3–83)	81.7 (29–85.7)	87.7 (83.7–93.3)	0.003^a a Statistical significance level.	G+ = G- < CG (0.039^b b CG showed significant higher scores as compared to G+ and G- in SOT3, SOT4, SOT5, SOT6, and CES conditions. )
SOT5 FT	Median (min–max)	47.7 (0–61.3)	0 (0–25.7)	68.7 (59.3–76)	0.001^a a Statistical significance level.	G+ = G- < CG (<0.001^b b CG showed significant higher scores as compared to G+ and G- in SOT3, SOT4, SOT5, SOT6, and CES conditions. )
SOT6 FT	Median (min–max)	4.3 (0–66.7)	0 (0–7.3)	66 (20–82.3)	0.003^a a Statistical significance level.	G+ = G- < CG (0.001^b b CG showed significant higher scores as compared to G+ and G- in SOT3, SOT4, SOT5, SOT6, and CES conditions. )
CES FT	Median (min–max)	58 (42–77)	51 (37–58)	81 (69–88)	0.002^a a Statistical significance level.	G+ = G- < CG (0.001^b b CG showed significant higher scores as compared to G+ and G- in SOT3, SOT4, SOT5, SOT6, and CES conditions. )
n		9	5	7

Groups		G+	G-	CG	Kruskal–Wallis test (p)	Tukey's multiple comparisons (p)
SOT1 RT	Median (min–max)	94 (90.3–95.3)	94.7 (90.7–95)	95.7 (94.7–97.7)	0.005^a a Statistical significance level.	G+ = G- < CG (0.012^b b CG showed significant higher scores than G- in SOT2 and SOT4. CG outperformed G+ and G- in SOT5, SOT6, and CES (CG > G+ > G-). )
SOT2 RT	Median (min–max)	90.3 (85–94.3)	89.3 (83–92)	94 (90.7–97.7)	0.012^a a Statistical significance level.	G- < CG (0.010^b b CG showed significant higher scores than G- in SOT2 and SOT4. CG outperformed G+ and G- in SOT5, SOT6, and CES (CG > G+ > G-). )
SOT3 RT	Median (min–max)	89.3 (76.3–95.7)	90 (80–95)	93.3 (92–97.7)	0.076	G+ = G- = CG
SOT4 RT	Median (min–max)	82 (64.3–88.3)	85.7 (40–90)	88.3 (85.3–95.3)	0.023^a a Statistical significance level.	G- < CG (0.050^b b CG showed significant higher scores than G- in SOT2 and SOT4. CG outperformed G+ and G- in SOT5, SOT6, and CES (CG > G+ > G-). )
SOT5 RT	Median (min–max)	64.3 (0–78.3)	0 (0–29.3)	74.7 (59.3–80.3)	0.007^a a Statistical significance level.	G- < G+ < CG (0.001^b b CG showed significant higher scores than G- in SOT2 and SOT4. CG outperformed G+ and G- in SOT5, SOT6, and CES (CG > G+ > G-). )
SOT6 RT	Median (min–max)	27.3 (0–70.7)	0 (0–0)	77.3 (38–81.7)	0.001^a a Statistical significance level.	G- < G+ < CG (<0.001^b b CG showed significant higher scores than G- in SOT2 and SOT4. CG outperformed G+ and G- in SOT5, SOT6, and CES (CG > G+ > G-). )
CES RT	Median (min–max)	66 (48–82)	52 (39–58)	83 (72–89)	0.001^a a Statistical significance level.	G- < G+ < CG (<0.001^b b CG showed significant higher scores than G- in SOT2 and SOT4. CG outperformed G+ and G- in SOT5, SOT6, and CES (CG > G+ > G-). )

		G+ (n = 9)	G- (n = 5)	CG (n = 7)	Kruskal–Wallis test (p)	Tukey's multiple comparisons (p)
P3 latency 2000/1000 Hz	Median (min–max)	351 (327–450)	423 (399–492)	342 (261–351)	0.006^a a Statistical significance level.	G- > G+ = CG (<0.001^a a Statistical significance level. )
P3 latency 1000/1500 Hz	Median (min–max)	345 (330–474)	457.5 (450–501)	351 (308–390)	0.023^a a Statistical significance level.	G- > G+ = CG (<0.001^a a Statistical significance level. )

Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Sede da Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico Facial, Av. Indianópolia, 1287, 04063-002 São Paulo/SP Brasil, Tel.: (0xx11) 5053-7500, Fax: (0xx11) 5053-7512 - São Paulo - SP - Brazil
E-mail: revista@aborlccf.org.br

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[1] *Corresponding author. E-mail:roseli.bittar@hc.fm.usp.br (R.S.M. Bittar).

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Hearing performance as a predictor of postural recovery in cochlear implant users☆ ☆ Please cite this article as: Greters ME, Bittar RS, Grasel SS, Oiticica J, Bento RF. Hearing performance as a predictor of postural recovery in cochlear implant users. Braz J Otorhinolaryngol. 2017;83:16-22.

Abstract

Objective

Methods

Results

Conclusion

Hearing performance as a predictor of postural recovery in cochlear implant users^☆ ☆ Please cite this article as: Greters ME, Bittar RS, Grasel SS, Oiticica J, Bento RF. Hearing performance as a predictor of postural recovery in cochlear implant users. Braz J Otorhinolaryngol. 2017;83:16-22.