Anuradha Shetye1. 1. Great Ormond Street Hospital for Children NHS Trust, London, UK. a_shetye@hotmail.com
Abstract
OBJECTIVE AND IMPORTANCE: Benign paroxysmal positional vertigo (BPPV) is an uncommon complication that can develop after cochlear implantation. This condition has been documented in adults as a complication of cochlear implant surgery. However, there is no reported literature on BPPV in children who have undergone cochlear implant surgery. CLINICAL PRESENTATION: A 13-year-old girl underwent the insertion of a cochlear implant and developed BPPV as a result of visiting fairground rides approximately 2 years after surgery. INTERVENTION: We performed a right Epley's maneuver. She was advised to do Brandt-Daroff exercises for 6 weeks. She became symptom free within a few weeks of doing vestibular rehabilitation exercises. Nevertheless, she had been compliant with vestibular rehabilitation for 6 weeks. CONCLUSION: The vibration injury to the labyrinth caused during the various rides could be analogous to the mechanism of trauma to the labyrinth as occurs during head injury. The other possibility could be dislodgement of the otoconia from the already vulnerable utricle that has been subject to cochlear implantation. It is presumed that the vulnerability of the labyrinth following the cochlear implantation happened as the child suffered from dizziness in the immediate post-operative period. However, a chance association between the insertion of the cochlear implant and the development of the symptoms of BPPV in this patient cannot be ruled out.
OBJECTIVE AND IMPORTANCE: Benign paroxysmal positional vertigo (BPPV) is an uncommon complication that can develop after cochlear implantation. This condition has been documented in adults as a complication of cochlear implant surgery. However, there is no reported literature on BPPV in children who have undergone cochlear implant surgery. CLINICAL PRESENTATION: A 13-year-old girl underwent the insertion of a cochlear implant and developed BPPV as a result of visiting fairground rides approximately 2 years after surgery. INTERVENTION: We performed a right Epley's maneuver. She was advised to do Brandt-Daroff exercises for 6 weeks. She became symptom free within a few weeks of doing vestibular rehabilitation exercises. Nevertheless, she had been compliant with vestibular rehabilitation for 6 weeks. CONCLUSION: The vibration injury to the labyrinth caused during the various rides could be analogous to the mechanism of trauma to the labyrinth as occurs during head injury. The other possibility could be dislodgement of the otoconia from the already vulnerable utricle that has been subject to cochlear implantation. It is presumed that the vulnerability of the labyrinth following the cochlear implantation happened as the child suffered from dizziness in the immediate post-operative period. However, a chance association between the insertion of the cochlear implant and the development of the symptoms of BPPV in this patient cannot be ruled out.