AUTHOR=Sluydts Morgana , De Laet Chloƫ , De Coninck Liesbeth , Blaivie Catherine , van Dinther Joost J. S. , Offeciers Erwin , Wuyts Floris L. , Zarowski Andrzej TITLE=Case report: Can cochlear implant stimulation lead to improved balance even after vestibular neurectomy? JOURNAL=Frontiers in Neurology VOLUME=14 YEAR=2023 URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2023.1248715 DOI=10.3389/fneur.2023.1248715 ISSN=1664-2295 ABSTRACT=Introduction

In a previous manuscript from our research group, the concept of vestibular co-stimulation was investigated in adult subjects who received a cochlear implant (CI). Despite what literature reports state, no signs of vestibular co-stimulation could be observed.

Results

In this case report, it was described how a woman, who previously underwent a neurectomy of the left vestibular nerve and suffers from bilateral vestibulopathy (BVP), reported improved balance whenever her CI on the left was stimulating. Unexpectedly, the sway analyses during posturography indeed showed a clinically relevant improvement when the CI was activated.

Discussion

Vestibular co-stimulation as a side effect of CI stimulation could not be the explanation in this case due to the ipsilateral vestibular neurectomy. It is more likely that the results can be attributed to the electrically restored auditory input, which serves as an external reference for maintaining balance and spatial orientation. In addition, this patient experienced disturbing tinnitus whenever her CI was deactivated. It is thus plausible that the tinnitus increased her cognitive load, which was already increased because of the BVP, leading to an increased imbalance in the absence of CI stimulation.