{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T10:03:24Z","timestamp":1789639404658,"version":"4.0.0"},"reference-count":52,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T00:00:00Z","timestamp":1789603200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Audiol. Res.","Audiology Research"],"abstract":"<jats:p>Background\/Objectives: Cochlear implantation (CI) effectively treats severe-to-profound sensorineural hearing loss, but its vestibular effects remain under investigation. This retrospective study assessed perioperative changes in horizontal canal function (video head impulse test, vHIT) and graviceptive perception (subjective visual vertical, SVV). Methods: Forty-three adults (mean age: 59 \u00b1 15 years) implanted between May 2017 and July 2018 were assessed pre- and postoperatively. The prespecified primary analysis was the paired comparison of vHIT gain at 60 ms in the implanted ear, performed separately by implantation side; all other comparisons were exploratory. Results: Paired vHIT data were available for 36 of 43 participants. Gain in the implanted ear did not change after right-sided CI (n = 17; 1.52 \u00b1 0.37 to 1.59 \u00b1 0.63; change: +0.07, 95% CI: \u22120.41 to 0.56; t(16) = 0.32, p = 0.754), whereas it fell after left-sided CI (n = 19; median: 1.41 to 1.07; z = \u22123.02, p = 0.003); the two sides were not compared formally. Implanted and non-implanted ears did not differ postoperatively (n = 37; p = 0.116). Fourteen of thirty-six participants (38.9%) developed new ipsilateral catch-up saccades (exact McNemar p = 0.031 and 0.039). SVV deviation was 0.77 \u00b1 0.47\u00b0 and 0.92 \u00b1 0.51\u00b0 (p = 0.086). Conclusions: No significant change was detected after right-sided CI or in SVV; given the wide confidence interval and the small sample, this is not evidence of preserved function. The left-sided reduction, the newly developed ipsilateral catch-up saccades and the exploratory findings require confirmation in larger prospective studies.<\/jats:p>","DOI":"10.3390\/audiolres16050136","type":"journal-article","created":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T08:03:17Z","timestamp":1789632197000},"page":"136","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Assessment of Horizontal Semicircular Canal and Graviceptive Perception Before and After Cochlear Implantation"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3603-4037","authenticated-orcid":false,"given":"Daniel","family":"H\u00e4ussler","sequence":"first","affiliation":[{"name":"Medical Faculty Mannheim, Ruprecht-Karls-University of Heidelberg, 68167 Mannheim, Germany"},{"name":"HNO Praxis Bad Sch\u00f6nborn, 76669 Bad Schonborn, Germany"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"},{"role":"visualization","vocabulary":"credit"},{"role":"formal-analysis","vocabulary":"credit"}]},{"given":"Dorotheea","family":"Cazan","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology Head and Neck Surgery, Helios Dr. Horst Schmidt Kliniken, 65199 Wiesbaden, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johannes","family":"Ludwig","sequence":"additional","affiliation":[{"name":"Medical Faculty Mannheim, Ruprecht-Karls-University of Heidelberg, 68167 Mannheim, Germany"},{"name":"Department of Radiology and Nuclear Medicine, University Hospital Mannheim, 68167 Mannheim, Germany"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"investigation","vocabulary":"credit"}]},{"given":"Klaus","family":"Fraas","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology Head and Neck Surgery, University Hospital Mannheim, 68167 Mannheim, Germany"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"investigation","vocabulary":"credit"}]},{"given":"Angela","family":"Schell","sequence":"additional","affiliation":[{"name":"Medical Faculty Mannheim, Ruprecht-Karls-University of Heidelberg, 68167 Mannheim, Germany"},{"name":"Department of Otorhinolaryngology Head and Neck Surgery, University Hospital Mannheim, 68167 Mannheim, Germany"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"methodology","vocabulary":"credit"},{"role":"conceptualization","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"supervision","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1537-8340","authenticated-orcid":false,"given":"Nicole","family":"Rotter","sequence":"additional","affiliation":[{"name":"Medical Faculty Mannheim, Ruprecht-Karls-University of Heidelberg, 68167 Mannheim, Germany"},{"name":"Department of Otorhinolaryngology Head and Neck Surgery, University Hospital Mannheim, 68167 Mannheim, Germany"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"supervision","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7683-7136","authenticated-orcid":false,"given":"Lena","family":"Zaubitzer","sequence":"additional","affiliation":[{"name":"Medical Faculty Mannheim, Ruprecht-Karls-University of Heidelberg, 68167 Mannheim, Germany"},{"name":"Department of Otorhinolaryngology Head and Neck Surgery, University Hospital Mannheim, 68167 Mannheim, Germany"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,17]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1007\/s00106-023-01310-0","article-title":"Structure and establishment of the German Cochlear Implant Registry (DCIR)","volume":"71","author":"Stover","year":"2023","journal-title":"HNO"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"69","DOI":"10.21053\/ceo.2019.01851","article-title":"Changes in Vestibular Symptoms and Function After Cochlear Implantation: Relevant Factors and Correlations with Residual Hearing","volume":"14","author":"Jang","year":"2021","journal-title":"Clin. Exp. Otorhinolaryngol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"2110","DOI":"10.1002\/lary.27071","article-title":"Meta-analysis of subjective complaints of vertigo and vestibular tests after cochlear implantation","volume":"128","author":"Hansel","year":"2018","journal-title":"Laryngoscope"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1007\/s00106-011-2434-5","article-title":"Rezeptorfunktion der Bogeng\u00e4nge Teil 1: Anatomie, Physiologie, Diagnostik und Normalbefunde","volume":"60","author":"Walther","year":"2012","journal-title":"HNO"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1159\/000504595","article-title":"The Superiority of the Otolith System","volume":"25","author":"Zarowski","year":"2020","journal-title":"Audiol. Neurootol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1007\/s00405-016-4007-4","article-title":"What vestibular tests to choose in symptomatic patients after a cochlear implant? A systematic review and meta-analysis","volume":"274","author":"Abouzayd","year":"2017","journal-title":"Eur. Arch. Otorhinolaryngol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"260","DOI":"10.1067\/mhn.2002.128555","article-title":"Histopathologic changes in the vestibule after cochlear implantation","volume":"127","author":"Tien","year":"2002","journal-title":"Otolaryngol. Head Neck Surg."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"417","DOI":"10.1016\/j.anorl.2018.10.007","article-title":"Impact of cochlear implantation on peripheral vestibular function in adults","volume":"135","author":"Colin","year":"2018","journal-title":"Eur. Ann. Otorhinolaryngol. Head. Neck Dis."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1186\/s40463-017-0224-0","article-title":"Effect of cochlear implant surgery on vestibular function: Meta-analysis study","volume":"46","author":"Ibrahim","year":"2017","journal-title":"J. Otolaryngol. Head Neck Surg."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"523","DOI":"10.1007\/s00405-014-3040-4","article-title":"Vestibular function and cochlear implant","volume":"272","author":"Robard","year":"2015","journal-title":"Eur. Arch. Otorhinolaryngol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1159\/000100348","article-title":"Vestibulo-ocular reflex","volume":"40","author":"Fetter","year":"2007","journal-title":"Dev. Ophthalmol."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Macdougall, H.G., McGarvie, L.A., Halmagyi, G.M., Curthoys, I.S., and Weber, K.P. (2013). The video Head Impulse Test (vHIT) detects vertical semicircular canal dysfunction. PLoS ONE, 8.","DOI":"10.1371\/journal.pone.0061488"},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Dieterich, M., and Brandt, T. (2019). Perception of Verticality and Vestibular Disorders of Balance and Falls. Front. Neurol., 10.","DOI":"10.3389\/fneur.2019.00172"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1016\/j.heares.2017.10.005","article-title":"An overview of cochlear implant electrode array designs","volume":"356","author":"Dhanasingh","year":"2017","journal-title":"Hear. Res."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"4273","DOI":"10.1007\/s00405-016-4183-2","article-title":"Reliability and comparison of gain values with occurrence of saccades in the EyeSeeCam video head impulse test (vHIT)","volume":"273","author":"Korsager","year":"2016","journal-title":"Eur. Arch. Otorhinolaryngol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1097\/MAO.0000000000001233","article-title":"Effect of Goggle Slippage on the Video Head Impulse Test Outcome and Its Mechanisms","volume":"38","author":"Suh","year":"2017","journal-title":"Otol. Neurotol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1215","DOI":"10.1007\/s00405-016-4157-4","article-title":"Video head impulse test: A review of the literature","volume":"274","author":"Alhabib","year":"2017","journal-title":"Eur. Arch. Otorhinolaryngol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"348","DOI":"10.1016\/j.anl.2012.11.002","article-title":"Detection of isolated covert saccades with the video head impulse test in peripheral vestibular disorders","volume":"40","author":"Blodow","year":"2013","journal-title":"Auris Nasus Larynx"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"463","DOI":"10.1007\/s00405-013-2376-5","article-title":"Caloric test and video-head-impulse: A study of vertigo\/dizziness patients in a community hospital","volume":"271","author":"Mahringer","year":"2014","journal-title":"Eur. Arch. Otorhinolaryngol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"16","DOI":"10.4274\/tao.2022.2022-1-4","article-title":"Instantaneous Gain in Video Head Impulse Test: A Reliability Study","volume":"60","author":"Kabis","year":"2022","journal-title":"Turk. Arch. Otorhinolaryngol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"537","DOI":"10.1111\/j.1749-6632.1992.tb25234.x","article-title":"Cyclorotation of the eyes and subjective visual vertical in vestibular brain stem lesions","volume":"656","author":"Brandt","year":"1992","journal-title":"Ann. N. Y Acad. Sci."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1093\/brain\/93.2.313","article-title":"The judgement of the visual vertical and horizontal with peripheral and central vestibular lesions","volume":"93","author":"Friedmann","year":"1970","journal-title":"Brain"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1016\/j.jns.2009.02.002","article-title":"Pattern of otolith dysfunction in posterior inferior cerebellar artery territory cerebellar infarction","volume":"280","author":"Kim","year":"2009","journal-title":"J. Neurol. Sci."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"2604","DOI":"10.1161\/STROKEAHA.113.001816","article-title":"Insular strokes cause no vestibular deficits","volume":"44","author":"Baier","year":"2013","journal-title":"Stroke"},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Piscicelli, C., Nadeau, S., Barra, J., and Perennou, D. (2015). Assessing the visual vertical: How many trials are required?. BMC Neurol., 15.","DOI":"10.1186\/s12883-015-0462-6"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"208","DOI":"10.1016\/j.rehab.2016.02.004","article-title":"Visual verticality perception after stroke: A systematic review of methodological approaches and suggestions for standardization","volume":"60","author":"Piscicelli","year":"2017","journal-title":"Ann. Phys. Rehabil. Med."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1136\/jnnp.2006.087791","article-title":"Influence of subjective visual vertical misperception on balance recovery after stroke","volume":"78","author":"Bonan","year":"2007","journal-title":"J. Neurol. Neurosurg. Psychiatry"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1159\/000095611","article-title":"The size of the cochlea and predictions of insertion depth angles for cochlear implant electrodes","volume":"11","author":"Escude","year":"2006","journal-title":"Audiol. Neurootol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1097\/00001648-199001000-00010","article-title":"No adjustments are needed for multiple comparisons","volume":"1","author":"Rothman","year":"1990","journal-title":"Epidemiology"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"343","DOI":"10.1016\/S0895-4356(00)00314-0","article-title":"Adjusting for multiple testing--when and how?","volume":"54","author":"Bender","year":"2001","journal-title":"J. Clin. Epidemiol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1198\/000313001300339897","article-title":"The Abuse of Power","volume":"55","author":"Hoenig","year":"2001","journal-title":"Am. Stat."},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"McGarvie, L.A., MacDougall, H.G., Halmagyi, G.M., Burgess, A.M., Weber, K.P., and Curthoys, I.S. (2015). The Video Head Impulse Test (vHIT) of Semicircular Canal Function\u2014Age-Dependent Normative Values of VOR Gain in Healthy Subjects. Front. Neurol., 6.","DOI":"10.3389\/fneur.2015.00154"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1159\/000362780","article-title":"Quantifying the vestibulo-ocular reflex with video-oculography: Nature and frequency of artifacts","volume":"20","author":"Mantokoudis","year":"2015","journal-title":"Audiol. Neurootol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"655","DOI":"10.3109\/00016489.2016.1154186","article-title":"Influence of cochlear implantation on vestibular function","volume":"136","author":"Chen","year":"2016","journal-title":"Acta Otolaryngol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"489","DOI":"10.1007\/s00405-012-1950-6","article-title":"Influence of cochlear implantation on the vestibular function","volume":"270","author":"Katsiari","year":"2013","journal-title":"Eur. Arch. Otorhinolaryngol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"254","DOI":"10.1016\/j.amjoto.2014.11.007","article-title":"Influence of insertion depth in cochlear implantation on vertigo symptoms and vestibular function","volume":"36","author":"Louza","year":"2015","journal-title":"Am. J. Otolaryngol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"e129","DOI":"10.1097\/AUD.0000000000000241","article-title":"Insertion Depth in Cochlear Implantation and Outcome in Residual Hearing and Vestibular Function","volume":"37","author":"Nordfalk","year":"2016","journal-title":"Ear Hear."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1016\/j.otohns.2007.09.003","article-title":"Does the surgical approach in cochlear implantation influence the occurrence of postoperative vertigo?","volume":"138","author":"Todt","year":"2008","journal-title":"Otolaryngol. Head Neck Surg."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"218","DOI":"10.1007\/BF00230003","article-title":"Human ocular torsional position before and after unilateral vestibular neurectomy","volume":"85","author":"Curthoys","year":"1991","journal-title":"Exp. Brain Res."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"576","DOI":"10.3109\/00016480903352967","article-title":"Subjective visual vertical in patients with ear surgery","volume":"130","author":"Ogawa","year":"2010","journal-title":"Acta Otolaryngol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1016\/j.heares.2015.04.017","article-title":"Endolymphatic hydrops is prevalent in the first weeks following cochlear implantation","volume":"327","author":"Smeds","year":"2015","journal-title":"Hear. Res."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"295","DOI":"10.3233\/VES-210053","article-title":"Cochlear implant surgery and perioperative dizziness is associated with utricular hyperfunction","volume":"32","author":"Truong","year":"2022","journal-title":"J. Vestib. Res."},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Lazzerini, F., Forli, F., Berrettini, S., Di Berardino, F., Pozzi, M., and Zanetti, D. (2026). Narrative Review on Vestibular Complaints After Cochlear Implantation in Adults: Defining Heterogeneous Common Symptoms. Audiol. Res., 16.","DOI":"10.3390\/audiolres16020050"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"e607","DOI":"10.1097\/MAO.0000000000002609","article-title":"Human Temporal Bone Study of Vestibular Histopathology in Cochlear Implant Patients with Cochlear Hydrops","volume":"41","author":"Lopez","year":"2020","journal-title":"Otol. Neurotol."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1097\/MAO.0000000000004037","article-title":"Post Cochlear Implantation Vertigo: Ictal Nystagmus and Audiovestibular Test Characteristics","volume":"45","author":"Kwok","year":"2024","journal-title":"Otol. Neurotol."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1007\/PL00007519","article-title":"Different forms of dizziness occurring after cochlear implant","volume":"258","author":"Kubo","year":"2001","journal-title":"Eur. Arch. Otorhinolaryngol."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"1027","DOI":"10.1097\/MAO.0b013e318280da2a","article-title":"Round window membrane insertion with perimodiolar cochlear implant electrodes","volume":"34","author":"Coordes","year":"2013","journal-title":"Otol. Neurotol."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"532","DOI":"10.1111\/coa.12558","article-title":"Quantitative analysis of gains and catch-up saccades of video-head-impulse testing by age in normal subjects","volume":"41","author":"Yang","year":"2016","journal-title":"Clin. Otolaryngol."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"833","DOI":"10.1152\/jn.00626.2015","article-title":"Vestibulo-spinal and vestibulo-ocular reflexes are modulated when standing with increased postural threat","volume":"115","author":"Naranjo","year":"2016","journal-title":"J. Neurophysiol."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"285","DOI":"10.1159\/000493845","article-title":"Viewing Target Distance Influences the Vestibulo-Ocular Reflex Gain when Assessed Using the Video Head Impulse Test","volume":"23","author":"Castro","year":"2018","journal-title":"Audiol. Neurootol."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"739","DOI":"10.1177\/0194599818779908","article-title":"Impact of Target Distance, Target Size, and Visual Acuity on the Video Head Impulse Test","volume":"159","author":"Judge","year":"2018","journal-title":"Otolaryngol. Head Neck Surg."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1007\/s00415-018-8986-5","article-title":"The video head impulse test: A right-left imbalance","volume":"265","author":"Strupp","year":"2018","journal-title":"J. Neurol."}],"container-title":["Audiology Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2039-4349\/16\/5\/136\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T09:13:15Z","timestamp":1789636395000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2039-4349\/16\/5\/136"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,17]]},"references-count":52,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2026,10]]}},"alternative-id":["audiolres16050136"],"URL":"https:\/\/doi.org\/10.3390\/audiolres16050136","relation":{},"ISSN":["2039-4349"],"issn-type":[{"value":"2039-4349","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,17]]}}}