STABILOMETRIC ANALYSIS OF POSTURAL STABILITY IN CHILDREN WITH BILATERAL CHRONIC SENSORINEURAL DEAFNESS AFTER COCHLEAR IMPLANTATION
DOI:
https://doi.org/10.37219/cwc0tr74Keywords:
cochlear implantation, sensorineural hearing loss, vestibular apparatus, postural control, computer stabilometry, binaural stimulation, childrenAbstract
Background: Children with profound sensorineural hearing loss and deafness frequently exhibit concomitant vestibular dysfunction, which is due to shared embryogenesis and the anatomical and physiological proximity of inner ear structures. Cochlear implantation (CI) significantly affects the labyrinth; however, the pattern of postural control alterations in pediatric practice remains a subject of ongoing debate.
Objective: To perform a stabilometric analysis of vestibular dysfunction characteristics in deaf children before and after cochlear implantation, and to evaluate its impact on patients' postural control and motor functions.
Materials and Methods: The study included 30 children (19 boys, 11 girls) aged 4-9 years with bilateral chronic sensorineural hearing loss. All patients underwent CI: simultaneous bilateral implantation was performed in 10 cases, and unilateral implantation in 20 cases. Computerized stabilometry (using the "Stabilis" hardware and software system, Ukraine) was performed preoperatively, on the 3rd postoperative day, and 12 months after surgery to register the center of pressure (COP) microdeviation parameters at rest. The control group consisted of 30 healthy age-matched children. Statistical analysis was performed using IBM SPSS Statistics 26.0 with the paired t-test.
Results: Pronounced orthostatic instability was detected in deaf children prior to surgery. On the 3rd postoperative day, an initial stage of vestibular adaptation was registered, accompanied by a moderate reduction in the statokinesigram area. At 12 months, a highly significant regression of stabilometric indices was observed (p < 0.01): the total trajectory length (Length) in children aged 4-6 years decreased from 8642.3 mm to 2567.6 mm, and in children aged 7-9 years from 4259.4 mm to 1007.3 mm; the average speed (AvgSpeed) decreased from 119.6 mm/s to 45.4 mm/s (4-6 years) and from 105.2 mm/s to 25.2 mm/s (7-9 years). The subgroup with simultaneous bilateral CI demonstrated maximum efficiency in balance recovery and deviation symmetry (RangeX parameter) due to the restoration of binaural stimulation. A weak negative correlation was found between the 12-month Length parameter and age at implantation (r = -0.32; p < 0.05). No statistically significant gender differences were found. Postoperative vertigo occurred in 5 patients and completely resolved within the first 3 months without pharmacological intervention.
Conclusions: Cochlear implantation acts as an effective trigger for systemic sensorimotor integration and central compensation of vestibular deficits in deaf children. The most complete recovery of postural control is achieved with simultaneous bilateral implantation performed at an early age. Computerized stabilometry serves as a sensitive and objective method for monitoring the rehabilitation process.
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