The Effect of Unilateral Saccular Dysfunction and Balance Deficits on Nonverbal Cognition and Auditory Perceptual Outcomes in Pediatric Cochlear Implantees.

OBJECTIVES

Vestibular dysfunction has implications for cognitive function, which in turn is important for the development of speech and language. A vestibular dysfunction after cochlear implantat (CI) surgery is not uncommon and therefore may be implicated in less-than-optimal cognitive function, which in turn could lead to worse post-implantation outcomes. However, these relationships have remained largely unexplored. Hence, the present study aimed to examine the differences in cognitive function and outcomes with the device among pediatric cochlear implantees with and without saccular dysfunction and balance deficits.

DESIGN

The study involved 51 participants, which included 17 children with unilateral CI (bimodal users) who had saccular dysfunction only on the implant side (CI-SD), 19 with unilateral CI (bimodal users) with normal balance and bilateral normal saccular function (CI-NF), and 15 typically developing children. All participants underwent a series of evaluations using the Nonverbal Index subtests of the Kaufman Assessment Battery for Children-Edition II, the Revised Categories of Auditory Performance, Infant-Toddler Meaningful Auditory Integration Scale, Integrated Scales of Development (ISD), and Modified Early Speech Perception Test in Kannada (MESP-K).

RESULTS

The performance of the typically developing children group on the Kaufman Assessment Battery for Children-Edition II was significantly better than both the CI groups ( p < 0.016). Furthermore, the CI-NF group had significantly better Nonverbal Index than the CI-SD group. The performance on MESP-K, Infant-Toddler Meaningful Auditory Integration Scale, and speech and cognition domains of ISD was significantly poorer in the CI-SD group than the CI-NF group ( p < 0.05).

CONCLUSIONS

Compared with hearing loss alone, the co-occurrence of saccular impairment is associated with more pronounced cognitive deficits and poorer outcomes. The study provides preliminary evidence for the adverse association of saccular dysfunction and balance deficits with cognition, speech perception, and overall outcomes in unilateral CI recipients.