Cochlear Implantation Outcomes in Patients With Migraine

Monday, September 30, 2024

9:36 AM – 9:42 AM EDT

Location: MBCC, 231

Disclosure(s):

Madison V. Epperson, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Seilesh C. Babu, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Crisshy H. Auguste, BS:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: Migraine has been associated with tinnitus, subjective hearing loss, sudden sensorineural hearing loss, and objective variations in audiometric outcomes. Migraineurs also have altered processing of sensory stimuli with lower discomfort thresholds and lack of normal habituation. Given these associations, it is important to understand how migraine may impact postoperative cochlear implantation (CI) experience and performance.

Methods: This was a multi-institutional retrospective case-control study of adults who underwent CI after 2006 with a coexisting diagnosis of migraine and age and sex-matched controls. Patients with cognitive impairment or neurodegenerative disease were excluded. Outcome measures included postoperative dizziness, tinnitus, narcotic refills, patient-provider electronic correspondence frequency, device usage, and speech perception outcomes using postoperative Consonant-Nucleus-Consonant (CNC) and AzBio in quiet scores.

Results: Statistical analyses were performed using Fisher’s Exact and Wilcoxon Rank-Sum tests. The study included 211 patients with median age of 59 years and 67% were female. In individuals without preoperative dizziness, migraineurs were more likely than controls to experience postoperative dizziness (65% vs. 35%, p=0.017). There was a higher rate of patient-provider postoperative e-communication in the two-week postoperative period in those with migraine, 1.5 [IQR 0-2] versus 1 [IQR 0-2], (p=0.017). There was no difference in postoperative tinnitus, hospital admission rate, or narcotic refills. For the migraine and non-migraine group, respectively, postoperative median CNC scores were 72% [IQR 44-88] and 68% [IQR 44-84] (p=0.34); median AzBio scores were 81% [IQR 58-94] and 80% [IQR 63-93] (p=0.90). There was no difference in daily implant usage (12.5 vs. 12.3 hours/day, p=0.60).

Conclusions: In those with migraine undergoing CI, there is a higher risk of postoperative dizziness, and there is greater postoperative electronic correspondence. Postoperative speech perception scores and daily device usage were comparable between groups.

Presenting Author(s)

Madison V. Epperson, MD

Surgical Resident
University of Michigan
Ann Arbor, MI, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Co-Author(s)

Lisa E. Chionis

Medical Student
University of Michigan Otolaryngology
Ann Arbor, MI, United States

Disclosure information not submitted.
RF

Rachel Fryatt, AuD

Audiologist
University of Michigan Department of Otolaryngology, Division of Audiology, United States

Disclosure information not submitted.
Jacob C. Lucas, MD

Neurotologist
Michigan Ear Institute
Novi, MI, United States

Disclosure information not submitted.

Presenting Author(s)

SB

Seilesh C. Babu, MD

Neurotology/Skull Base Surgery
Michigan Ear Institute
Farmington Hills, Michigan, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Senior Author(s)

Emily Z. Stucken, MD

Clinical Associate Professor
University of Michigan
Ann Arbor, MI, United States

Disclosure information not submitted.

Co-Author(s)

Crisshy H. Auguste, BS

Medical Student
Wayne State School of Medicine
Detroit, MI, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.