ABSTRACT
Vestibular lesions are found after cochlear implantation in 23-100 % of cases. The objectives of this study were to evaluate the vestibular function before and after implantation while focusing its feasibility. This prospective study included 35 patients, mean age 49 years. Each patient enjoyed a vestibular balance before and after implantation in a median period of 5 months compared to surgery. Vestibular evaluations were performed using vestibular-evoked myogenic potentials (VEMP) and videonystagmography. Before implantation, the VEMPs were bilateral in 73 % of cases. They are modified after implantation for 13 patients, including 12 missing or reduced potentials on implanted side (p = 0.0015). Caloric tests found themselves a significant decrease in the reflectivity of the ear implanted (p < 0.0001). Vestibular symptoms were independent of changes on vestibular tests. No relation was found between the occurrence of post-operative vestibular symptoms and the results of the vestibular investigations. However, the achievement of these exams is not easy especially for children and only part of the vestibule is tested. In conclusion, the vestibular assessments help to choose the side of implantation, assess the pre-operative vestibular condition and assess and locate vestibular lesions induced. Further tests should enable a complete vestibular assessment.
Subject(s)
Cochlear Implantation/adverse effects , Vestibule, Labyrinth/physiology , Vestibule, Labyrinth/physiopathology , Adolescent , Adult , Aged , Aged, 80 and over , Caloric Tests , Child , Child, Preschool , Cochlear Implants , Deafness/surgery , Female , Humans , Infant , Male , Middle Aged , Postoperative Period , Preoperative Period , Prospective Studies , Prosthesis Design , Vestibular Evoked Myogenic Potentials , Young AdultABSTRACT
The quality of life of patients treated for head and neck cancers and their carers is part of the current concerns of health care teams. Assessment tools were created and helped to highlight the severe physical effects (pain, mucositis ) and chronic (mutilation, post-radiation complications ) related to the disease or to different treatments but also to consider the psychosocial impact of this disease. Improving the quality of life through a thoughtful and comprehensive support that must be associated with somatic care, mental health care, rehabilitation and inclusion of social difficulties and suffering relatives. Supportive care shall ensure a good quality of life for patients treated and their families but also reduce the physical effects associated with the disease and treatment. They rely on coordination of care including the cancer networks established in the cancer plan to ensure comprehensive and continuous care for these patients.
