Importance: Vestibular disorders have been reported following cochlear implant (CI) surgery, but the literature shows a wide discrepancy in the reported clinical impact. The aim of this meta-analysis is to quantify the effect of CI before and after surgery on the outcomes of vestibular tests, postural stability, and subjective perception of dizziness. Objective: To evaluate the effects of CI surgery on vestibular function in adult patients (≥18 years) with sensorineural hearing loss who underwent unilateral or bilateral implantation. Data sources: MEDLINE, PubMed, Web of Science and Cochrane Library from January 1, 1995, through July 12, 2016. Study selection: Published studies of adult patients who received unilateral or bilateral CIs and whose vestibular function or postural stability was assessed before and after surgery. Data extraction: From each study, test results before and after surgery were compared, for the following five tests: clinical head impulse test (HIT); bi-thermal caloric irrigation of the horizontal semicircular canal; vestibular evoked myogenic potential (VEMP); dizziness handicap inventory (DHI); and computerized dynamic posturography (CDP). Results: Twenty-seven studies met all inclusion criteria. Most studies performed either bi-thermal caloric irrigation and/or VEMP, with fewer studies investigating changes in HIT, posturography or DHI. CI surgery significantly affected the results of caloric and VEMP testing. However, HIT results, posturography, and DHI, scores were not significantly affected after CI surgery. Conclusions and relevance: CI surgery has a significant negative effect on the results of caloric as well as VEMP tests. No significant effect of CI surgery was detected in HIT, posturography, or DHI scores. Overall, the clinical effect of CI surgery on the vestibular function was found to be insignificant. Nonetheless, the potential effects of surgery on the vestibular system should be discussed with CI candidates before surgery.

Importance: Sudden sensorineural hearing loss (SSNHL) is an otological emergency of unknown etiology. Recent reports showed that antioxidant drugs can benefit patients with SSNHL. This study attempted to evaluate the effect of adding antioxidant vitamins as an adjuvant therapy alongside with corticosteroids. Objective: To evaluate the effects of the 3 major antioxidant vitamins (A, C, and E) as an adjuvant therapy, administered with corticosteroids, for the treatment of SSNHL in adult patients (≥18 years). Data Sources: MEDLINE, EMBASE, PubMed, Web of Science and Cochrane electronic databases from January 1, 1995, through September 25, 2017. Study Selection: Published studies of adult patients who received antioxidant vitamins (A, C, E, or any combination of these vitamins) as an adjuvant therapy in addition to the regular treatment (corticosteroids) for SSNHL. Quality assessment was performed using the Cochrane Collaboration Tool for Assessing Risk of Bias. Data Extraction: Each study had a control group (conventional treatment + placebo) and a trial group (antioxidant vitamin(s) + conventional treatment). Results: From 446 manuscripts identified in the literature, 3 studies were included in the review with 279 patients. The most common vitamins used to treat SSNHL were the 3 major antioxidant vitamins A, C, and E, combined sometimes with other antioxidants such as selenium. Conclusions and Relevance: The success of the treatment is increased in patients who received antioxidant vitamins in combination with conventional therapy.

Purpose: Dizziness is the most common complaint of patients over 65 years consulting a physician. Presbyacusis affects 65% of Canadians aging 70–79. The inner ear is responsible for both hearing and postural stability. However, the interactions between auditory information and the maintenance of postural balance have not been widely studied. The aim of this study is to evaluate and compare the effect of auditory input on postural stability for normal hearing subjects versus hearing-aid users. Methods: The effect of auditory input on postural stability was assessed with and without earplugs in normal subjects, and in adult hearing users with and without hearing aids. Balance tests (Romberg on foam and Tandem stance) were performed in the presence of a point-source of noise in both groups. Results: Normal individuals’ balance performance was not affected by the absence of auditory input. However, hearing aid users had significantly better balance with hearing aids on for the Romberg test (v = 36, p = .014), and for the Tandem test (v = 44, p = .012). Conclusion: Auditory input does not seem to have an effect on postural stability in normal hearing individuals. However, hearing aid users had a significant improvement in the presence of an auditory input.