Balance versus hearing after cochlear implant in an adult

The effect of vestibular rehabilitation (VR) on anxiety, dizziness and poor balance that developed after cochlear implant (CI) surgery is described. A 54-year-old woman, with profound hearing loss since the age of 2 years, underwent right CI surgery 2 years previously. On implant activation, the patient immediately felt dizziness and imbalance, which affected the ability to perform activities of daily living and increased anxiety to where the patient considered the CI removal. Prior to VR the patient was evaluated with the Dizziness Handicap Inventory and the Visual Vertigo Dizziness Questionnaire and clinically with the Zur Balance Scale and Video Head Impulse Test. The patient underwent 14 VR sessions over 4 months that included compensation, adaptation and habituation exercises. After VR the patient was able to maintain good balance while using the CI. Dizziness and anxiety improved dramatically. This report increases awareness that a CI could compromise balance, which can be overcome with personalised VR.