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Vestibular assessment in children with sensorineural hearing loss using both electronystagmography and vestibular-evoked myogenic potential

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Abstract

Background

The clinical course and prognosis in sensorineural hearing loss (SNHL) may be even worse if the vestibular system is also involved, especially because of near location of the anatomic structures in the inner ear. However, vestibular function in children with SNHL appears to be under-reported. The aim of the study was to assess the vestibular function and to determine the prognostic value of some etiological, audiological, and demographic (age, sex) factors in predicting a possibility of vestibular impairment for very early identification of children with vestibular deficits.

Materials and methods

The control group consisted of 30 children with normal hearing (17 girls and 13 boys) and the study group consisted of 50 children with varying degrees of bilateral SNHL, aged between 5 and 15 years. All of them were subjected to the following: basic audiological evaluation (pure-tone, speech audiometry), immittancemetry and auditory brainstem responses, electronystagmography (ENG), and vestibular-evoked myogenic potential (VEMP).

Results

Hearing impaired (HI) children showed bilateral SNHL of various degrees ranging from moderate to profound hearing loss (HL) [moderate-severe (32%), severe (18%), and profound (50%)] and of different etiologies [heredofamilial (46%), acquired (38%), not known (16%)]. Abnormal ENG findings were recorded in 64% of HI children. Abnormal caloric test findings were found in 56% of the HI children with heredofamilial cause of HL, in 84.2% with acquired HL, and in 37.5% with unknown cause. These results according to the degree of HL were 37.5, 55.5, and 76% for moderate, severe, and profound HL, respectively. It was noticed that HI children with profound degree and acquired etiology of HL had the highest abnormal caloric findings. Abnormal VEMP was found in 72% of HI children, but this percentage varied according to the different etiologies, 56.5, 84, and 75% for heredofamilial, acquired, and unknown, respectively. Bilateral saccular affections were more common than unilateral. HI children with profound HL had the highest percentage of both bilateral and unilateral saccular affections in the absence of VEMP.

Conclusion

Vestibular deficits occur in a significant percentage of HI children. Abnormal ENG and VEMP findings in HI children varied according to the etiology and or the degree of HL; those with acquired etiology and/or profound degree of HL had the highest abnormal scores.

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Correspondence to Eman Abdel-Fattah Said.

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Said, E.AF. Vestibular assessment in children with sensorineural hearing loss using both electronystagmography and vestibular-evoked myogenic potential. Egypt J Otolaryngol 30, 43–52 (2014). https://doi.org/10.4103/1012-5574.127203

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Keywords

  • electronystagmography
  • prognostic factors
  • sensorineural hearing loss
  • vestibular-evoked myogenic potential