Balance Assessment of Children with Sensorineural Hearing Loss
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ORIGINAL ARTICLE
Balance Assessment of Children with Sensorineural Hearing Loss Kumari Apeksha1 • Sanjana Singh1 • Monica Rathnamala1 • S. Varalakshmi2 D. J. Preethu2 • V. Kavya2 • D. S. Sowndarya2 • S. Arpitha2 • K. Milana2 • S. Navya2 • M. Analey Thejasvi2
•
Received: 26 December 2019 / Accepted: 22 January 2020 Ó Association of Otolaryngologists of India 2020
Abstract This study aimed to assess the balance function in children with sensorineural hearing loss (SNHL) using different tests to assess vestibulospinal pathway and tests to assess vestibular system and to compare the result obtained with those of children with normal hearing sensitivity. Detailed balance assessment was done for 15 children with severe to profound SNHL and 15 children with normal hearing sensitivity in the age range of 6–10 years. The audiological evaluation included pure-tone audiometry, speech audiometry, immittance evaluation, otoacoustic emission, vestibular evoked myogenic potential (cervical VEMP and ocular VEMP), and tests to assess vestibulospinal pathway and cerebellar function, such as Romberg test, Fukuda stepping test, Tandem gait test, and Finger-tonose test. cVEMP and oVEMP were absent in 8 ears (27%) of a total of 30 ears with SNHL. Statistical analysis shows no significant difference between latency and amplitude of cVEMP peaks and latency of oVEMP peaks across groups. Significant reduction of oVEMP peaks amplitude was seen in children with SNHL compared to children with normal hearing. Fukuda stepping test showed an abnormal response in 2 children with SNHL (13%) and one child could not perform tandem gait test (7%). Children with SNHL showed an evident abnormality on the balance assessment test results. The abnormal function of the vestibular system and the vestibulospinal pathway can
& Kumari Apeksha [email protected] 1
Department of Speech and Hearing, JSS Institute of Speech and Hearing, MG Road, Mysore, India
2
JSS Institute of Speech and Hearing, MG Road, Mysore, India
compromise the child’s motor development and thus needs investigation early in life. Keywords Vestibular evoked myogenic potential Fukuda stepping test Tandem gait test Finger-to-nose test Sensorineural hearing loss
Introduction Maintenance of balance requires a coordinated action involving sensory information from the vestibular system, proprioceptive system, and visual system with the help of vestibular-ocular reflex, vestibule-colic reflex and vestibule-spinal reflex [1]. Since the cochlea and the vestibular system lies in close proximity to each other and also share the germ layers, it is not surprising to have some degree of abnormal vestibular symptoms in individuals with sensorineural hearing loss [2]. The prevalence of dizziness and balance problem was reported to be 5.7% [3] and 5.3% [4] in children without significant hearing loss and 38% had some degree of vestibular loss in 186 children with hearing loss [5]. The most frequent dizziness and balance symptoms reported by children were poor coordination in 46% of th
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