Vestibular Deficits in Deaf Children

Abstract

Considerable knowledge has been accumulated regarding acquired and congenital deafness in children. However, despite the intimate relationship between the auditory and vestibular systems, data are limited regarding the status of the balance system in these children. Using a test population of 15 children, aged 8 to 17 years, we performed electronystagmography testing. The test battery consisted of the eye-tracking (gaze nystagmus, spontaneous nystagmus, saccade, horizontal pursuit and optokinetic) tests, positional/positioning (Dix-Hallpike and supine) tests, and rotational chair tests. With age-matched controls, five children were tested in each of the following three categories: normal hearing, hereditary deafness, and acquired deafness. The children in the hereditary deafness category were congenitally deaf and had a family history of deafness. Those subjects in the acquired deafness category had hearing loss before the age of 2 years, after meningitis. Analysis of variance demonstrated significant differences between the two deaf groups and the control subjects in the gaze nystagmus test, saccade latencies, horizontal pursuit phase, and Dix-Hallpike and supine positionally provoked nystagmus. Also, significant differences were found in rotational chair gain and phase between the deaf and normal-hearing children. The children with acquired deafness exhibited the most profound results. In addition, there were significant differences in rotational chair gain between the acquired and congenitally deaf children. No differences were noted in horizontal pursuit gains, saccade accuracies, or saccade asymmetries. These preliminary data demonstrate that the etiologic factors responsible for congenital and acquired deafness in children may indeed affect the balance system as well. These findings of possible balance disorders in conjunction with the profound hearing loss in this patient population will have prognostic implications in the future evaluation, treatment, and rehabilitation of these patients.

Influencing Factors on the Vestibular Function of Deaf Children and Adolescents - Evaluation by Means of Dynamic Posturography

“…Potter and Silverman observed hypoactive (postrotatory) vestibular responses in just under 60 % of their test population, 34 deaf children [9] whereas Horak et al (1988) cite a figure of 66 % [6]. Selz et al also describe a significant difference in the vestibular function of deaf and hearing children (with reference to rotatory tests) ( [12]. Horak et al (1988) report a strong correlation between VOR tests (postrotatory in this study) and performance in the SOT.…”

“…This hypothesis is supported by studies which show that vestibular dysfunction has a high frequency (up to 80 %) in children with severe hearing impairment [7][8][9][10][11][12][13]. The methods used involved assessment of either postrotatory or caloric nystagmus.…”

Hearing-impaired young people – a physician’s guide

“…[20][21][22][23][24][25] This is under recognised. These children have delayed motor skills or may be described as 'clumsy'.…”

Age-related changes of single-limb standing balance in children with and without deafness

“…Previous studies have found that 49-95% of children with hearing loss suffered from vestibular dysfunction, with the incidence increasing with the degree of hearing loss (Selz et al 1996). The cochlear and vestibular systems are anatomically and functionally connected, and so damage to either the cochlear or vestibular systems, or both, can lead to vestibular disorder and associated balance dysfunction (Rine et al 2000).…”