Simultaneous labyrinthectomy and cochlear implantation in unilateral meniere's disease.

OBJECTIVE

In a single-institution, FDA-approved IDE study, subjects with unilateral Meniere's disease and intractable vertigo underwent concurrent labyrinthectomy and cochlear implantation to determine speech perception, localization, and quality of life outcomes.

METHODS

Three subjects with unilateral Meniere's disease with normal or near-normal hearing in the contralateral ear underwent simultaneous labyrinthectomy and cochlear implantation. Sound localization, speech perception in noise and quiet, tinnitus handicap index, and quality of life measures were evaluated at 1, 3, and 6 months after implant activation.

RESULTS

Sound localization testing demonstrated immediate benefit postimplantation with the cochlear implant (CI). RMS error with CI on was 22 degrees (±2) and with CI off was 63 (±15) at 6 months. Mean CI alone scores were 22% (±20) at 1 month and improved to 43% (±20) and 49% (±11) at the 3- and 6-month intervals, respectively. AzBio sentences in babble (0 dB SNR) scores presented in the most challenging listening condition (S0NContra) were 28% (±20) at 1 month, 38% (±18) at 3 months, and 45% (±24) at 6 months. Tinnitus Handicap Inventory (THI) significantly improved from an average preoperative score of 42 (±26) to 0 at 6 months. Quality of life measures improved overall over the postimplantation follow-up intervals.

CONCLUSIONS

Subjects with unilateral Meniere's Disease who underwent simultaneous labyrinthectomy and cochlear implantation experienced improvements in sound localization, speech understanding, tinnitus severity, and quality of life with device use. There was a trend for better performance over the postoperative intervals.

LEVEL OF EVIDENCE: 2b.