Vestibular testing in children with severe-to-profound hearing loss

Kotait, Mona Ahmed; Moaty, Asmaa Salah; Gabr, Takwa A.

doi:10.1016/j.ijporl.2019.07.015

Cited by 17 publications

(7 citation statements)

References 22 publications

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“…The prevalence of VH in this study was comparable to earlier reports ( 4 , 6 , 13 , 22 , 42 , 43 ). The lack of a gold standard creates a wide range in prevalence of VH, since some of the studies based the diagnosis of VH on a single vestibular test.…”

Section: Discussionsupporting

confidence: 91%

Vestibular assessment in children with sensorineural hearing loss: diagnostic accuracy and proposal for a diagnostic algorithm

Gerdsen,

Hundscheid,

Boudewyns

et al. 2024

Front. Neurol.

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IntroductionVestibular assessment in children with sensorineural hearing loss (SNHL) is critical for early vestibular rehabilitation therapy to promote (motor) development or guide decision making towards cochlear implantation (timing of surgery and laterality). It can be challenging from a clinical viewpoint to decide which vestibular tests should be performed for a pediatric patient. The aim of this study was to evaluate the diagnostic accuracy of several clinically available vestibular tests in children with SNHL, and to provide recommendations for the implementation of vestibular testing of children in clinical practice, to screen for vestibular hypofunction (VH).MethodsA two-center retrospective chart review was conducted. Eighty-six patients between the age of 0 and 18 years were included in this study with SNHL. Vestibular tests included video headimpulse test (VHIT), caloric test (performed at the age of four or higher), rotatory chair and cervical vestibular evoked myogenic potential (cVEMP). A combination of the clinical assessment and (combinations of) vestibular test outcomes determined the diagnosis. The diagnostic quality of tests and combination of tests was assessed by diagnostic accuracy, sensitivity and specificity.ResultsVH was diagnosed in 44% of the patients. The VHIT and caloric test showed the highest diagnostic accuracy compared to the rotatory chair and cVEMP. All combinations of VHIT, caloric test and cVEMP showed improvement of the diagnostic accuracy compared to the respective tests when performed singularly. All combinations of tests showed a relatively similar diagnostic accuracy, with the VHIT combined with the caloric test scoring the highest. Adding a third test did not substantially improve the diagnostic accuracy.DiscussionVestibular testing is feasible and VH is highly prevalent in children with SNHL. A proposed diagnostic algorithm recommends starting with VHIT, followed by cVEMP for children under the age of four, and caloric testing for older children if VH is not confirmed with the first test. Performing a third test is redundant as the diagnostic accuracy does not improve substantially. However, challenges remain, including the lack of a gold standard and the subjective nature of the diagnosis, highlighting the need for standardized testing and increased understanding of VH in this population.

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Section: Discussionsupporting

confidence: 91%

Vestibular assessment in children with sensorineural hearing loss: diagnostic accuracy and proposal for a diagnostic algorithm

Gerdsen,

Hundscheid,

Boudewyns

et al. 2024

Front. Neurol.

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“…This results may be due to close anatomic and developmental relationship between cochlear and vestibular system. These results also agreed with, Kotait et al, [12] whom SHA test results showed 16 children (50%) had abnormal results: seven (21.88%) children had unilateral peripheral vestibular hypofunction and three children (9.37%) had bilateral vestibular hypofunction and six children (18.75%) had bilateral severe vestibular hypofunction with severe gain affection and out of range results of both the phase and symmetry.…”

Section: Discussionsupporting

confidence: 91%

Vestibular Evaluation Using Rotatory Chair in Children with Cochlear Implants

Salem

Emara

Kolkaila

et al. 2021

Egyptian Journal of Ear, Nose, Throat and Allied Sciences

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Introduction:Cochlear Implant surgery is a procedure to overcome the problem of severe to profound sensorineural hearing loss with no benefit from hearing aids. Although, it may cause postoperative changes of vestibular function. Vestibular evaluation is necessary to detect vestibular affection after surgery. Aim: Vestibular evaluation in severe or severe to profound hearing loss children and cochlear implanted children by using Arabic Dizziness Handicap Inventory for children (DHI), vestibular bed-side tests for children and Rotatory chair testing.. Patients and Methods: This work included 60 children divided into three groups: group I (GI) consisted of 20 normal hearing children, group II (GII) consisted of 20 bilateral severe or severe to profound hearing loss children and group III (GIII) consisted of 20 unilateral cochlear implanted children. They were evaluated by full audiological evaluation, Arabic DHI for children, vestibular bed-side tests for children, Sinusoidal harmonic acceleration (SHA) and velocity step test (VST) of Rotatory Chair. Results: This study showed significant affection in the Arabic DHI for children, Sharpened Romberg test and Fukuda Stepping test. Rotatory chair results in GII showed, ten children with unilateral peripheral vestibular affection and three children with bilateral vestibular affection. While GIII showed, eight children with unilateral peripheral vestibular affection ipsilateral to side of implantation and three children with bilateral vestibular affection. Conclusion: Arabic DHI for children is a good valuable tool to detect parental observation of vestibular affection in children. Also, Rotatory chair test is a valid and non-invasive test for detection of vestibular affection in children.

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“…However, this is changing. Emerging evidence suggests that 15 to 80% of children with hearing loss have concomitant vestibular impairment (Rine et al 2000; Singh et al 2012; Verbecque et al 2017; Janky et al 2018; Kimura et al 2018; Kotait et al 2019). While there is considerable variability in the reported prevalence due to methodological differences across studies, the rates of concomitant dysfunction may suggest that pediatric vestibular dysfunction may be an underrecognized clinical condition among children with hearing loss.…”

Section: Introductionmentioning

confidence: 99%

A Systematic Review on the Association Between Vestibular Dysfunction and Balance Performance in Children With Hearing Loss

et al. 2021

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Objectives:The objective of this study was to understand the functional impact of vestibular dysfunction on balance control in children with hearing loss. The vestibular system is an important contributor to maintaining balance. In adults, vestibular dysfunction is known to lead to unsteadiness and falls. Considerably less is known about the effects of vestibular dysfunction in children with hearing loss. Design:We conducted a systematic review in concordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. We included articles on children with hearing loss who underwent vestibular and balance testing. The Downs and Black checklist was used to assess the risk of bias.Results: A total of 20 articles were included in this systematic review, of which, 17 reported an association between vestibular dysfunction and balance abnormalities in children with hearing loss. Bias (as measured by the Downs and Black Checklist) was a concern, as most studies were nonblinded cohort studies or case series selected through convenience sampling. Conclusions:Research to date has predominantly found that children with concomitant hearing loss and vestibular impairment tend to perform more poorly on balance measures than either children with hearing loss and normal vestibular function or children with both normal-hearing and normal vestibular function. A standardized approach to assessing both vestibular function and balance would better characterize the impact of vestibular dysfunction in children with hearing loss at the population level.

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Vestibular testing in children with severe-to-profound hearing loss

Cited by 17 publications

References 22 publications

Vestibular assessment in children with sensorineural hearing loss: diagnostic accuracy and proposal for a diagnostic algorithm

Vestibular assessment in children with sensorineural hearing loss: diagnostic accuracy and proposal for a diagnostic algorithm

Vestibular Evaluation Using Rotatory Chair in Children with Cochlear Implants

A Systematic Review on the Association Between Vestibular Dysfunction and Balance Performance in Children With Hearing Loss

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