Background

Profound hearing loss is a public health problem with serious consequences for patient's quality of life. Some of them, submitted to cochlear implantation, revealed various postural disorders such as balance and spatial perception disorders without detail on their vestibular status.

Research question

The purpose of this preliminary study was to analyze the evolution of the balance control and geocentric perception after cochlear implantation procedure in normo-reflexic patients before the implant activation.

Methods

We assessed balance control of five patients with profound hearing loss and five healthy participants by means of computerized dynamic posturography and their geocentric perception by the subjective visual vertical test before surgery, three days and forty-five days after surgery (prior to implant activation).

Results

Before surgery, the patients showed some difficulties to control their balance in challenged postural context without geocentric perception disorder. Patients presented an improvement in their postural accuracy, but their balance control remained inappropriate in challenging environment. Moreover, their geocentric perception was deviated towards their healthy ear immediately after cochlear implantation. This misperception naturally fades before the implant activation.

Significance

This transient spatial perception alteration might probably cause the perceived postural discomforts and the daily difficulties often reported by these patients in their clinical records early after cochlear implantation. This preliminary study allows for the first time the distinction between the both components of posture: balance control and geocentric perception. Therefore, a specific therapeutic care targeting the rehabilitation of spatial cognition could be proposed to these patients in order to reduce their transient postural disorders.

中文翻译：

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正常反射患者人工耳蜗植入引起的姿势障碍：暂时性地心知觉障碍的潜在起源。

背景

深度听力损失是一项公共健康问题，严重影响患者的生活质量。他们中的一些人接受了人工耳蜗植入，发现了各种姿势障碍，例如平衡和空间知觉障碍，但没有前庭状态的详细信息。

研究问题

这项初步研究的目的是分析正常反射患者在植入物激活前进行人工耳蜗植入后平衡控制和地心知觉的演变。

方法

我们通过计算机动态动态体位描记术和五位健康参与者的平衡控制情况，通过计算机动态动态体位描记术进行了评估，并通过术前，术后三天和四十五天（植入物激活前）的主观视觉垂直测试对他们的地心知觉进行了评估。

结果

手术前，患者在没有地心知觉障碍的挑战性姿势中表现出一些难以控制自己的平衡的困难。患者的姿势准确性有所改善，但在充满挑战的环境中，他们的平衡控制仍然不合适。而且，在人工耳蜗植入后，他们的地心感知立即偏离了健康的耳朵。这种误解在植入物激活之前自然消失。

意义

这种短暂的空间知觉改变可能会导致这些患者在人工耳蜗植入后的早期临床记录中经常报告的姿势不适和日常困难。这项初步研究首次将姿势的两个组成部分区分开：平衡控制和地心知觉。因此，可以针对这些患者提出针对空间认知康复的特殊治疗，以减少其短暂的姿势性疾病。