Science Update

New scientific studies summarized for you

Cochlear Implants in Menière’s Disease

(Original title: Hearing and Vestibular Outcomes in Patients Undergoing Labyrinthectomy and Cochlear Implant in End-Stage Menière’s Disease”, 2025, Almashhadani et al.)

Key Message
Simultaneous labyrinthectomy and cochlear implantation (CI) is an effective treatment for patients with end-stage Menière’s disease (MD), offering significant improvements in hearing, vertigo control, and tinnitus, especially in younger patients.

Background
In advanced stages of Menière’s disease, patients may experience profound hearing loss and intractable vertigo. While labyrinthectomy effectively controls vertigo, it sacrifices residual hearing. Cochlear implantation offers a solution for hearing restoration. This study investigates the combined approach of labyrinthectomy and CI, performed either simultaneously or sequentially, as a comprehensive treatment for end-stage MD.

• Method

– Retrospective study
– 39 patients treated between 2014 and 2023
  Mean age: 59.3 years;
  24 patients <65 years
  15 patients >65 years

Severe-profound hearing loss

Intractable vertigo

Unilateral (22 patients) or bilateral MD (10 pt) or secondary menieriform disorders (7 pt)

Average follow-up duration: 28 months

• Evaluation

– Pure Tone Audiometry (PTA) and Speech Discrimination Scores (SDS) for hearing
– Dizziness Handicap Inventory (DHI) for vertigo
– Tinnitus Handicap Inventory (THI) for tinnitus
– Subgroup analyses were conducted based on age (<65 vs. ≥65) and MD type (unilateral, bilateral, or secondary).

• Results
  Hearing
  – Significant improvement in PTA
  – SDS improved overall, especially in younger patients and those with bilateral MD
  – Patients with contralateral hearing aids showed enhanced binaural benefitsVertigo
  – DHI scores improved significantly
  – 54% of patients experienced complete resolution of vertigo
  – Older patients (≥65) showed less vestibular compensation

  Tinnitus
  – THI scores dropped significantly
  – Most patients reported subjective tinnitus relief when the CI was active

  Safety
  – No adverse surgical outcomes were reported
  – Simultaneous procedures reduced surgical burden and risk of cochlear ossification

Conclusion
Simultaneous labyrinthectomy and cochlear implantation is an effective approach for managing both hearing loss and vertigo in patients with end-stage Menière’s disease, offering significant benefits in hearing restoration, tinnitus suppression, and vertigo control. Careful patient selection and counselling are essential.

(Read the full paper here: Otology & Neurotology)