Implications of Concurrent Vestibular Dysfunction in Pediatric Hearing Loss
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HEARING LOSS IN CHILDREN (D HORN AND H OU, SECTION EDITORS)
Implications of Concurrent Vestibular Dysfunction in Pediatric Hearing Loss Melissa Hazen 1 & Sharon L. Cushing 2,3,4,5,6
# Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose of the Review It is known that the prevalence of vestibular impairment in children with sensorineural hearing loss (SNHL) is high and can lead to balance deficits. In this review, we look beyond balance and consider the impact of this multisensory deficit on neurocognitive function and navigation with the aim of explaining some of the variability in outcomes seen in cochlear implant populations, considering how to ameliorate these outcomes with targeted rehabilitative strategies. Recent Findings Congenital or early acquired vestibular impairment associated with SNHL impacts multiple cognitive domains including spatial memory. The attentional demands of maintaining postural stability are also significant and receive priority over other competing tasks, leading to a broader impact in everyday life. Summary Vestibular impairment is common in children with SNHL and impacts their daily function. Early recognition of vestibular deficits is key and several promising therapeutic approaches, including the restoration of bilateral and potentially binaural hearing, are currently under investigation. Keywords Vestibular impairment . Hearing loss . Cochlear implant . Balance . Postural stability . Development
Introduction The longstanding history of excellence in research examining the prevalence of vestibular impairment and the implications thereof in children with sensorineural hearing loss (SNHL) This article is part of the Topical collection on Hearing Loss in Children * Sharon L. Cushing [email protected] Melissa Hazen [email protected] 1
Department of Communication Disorders, Hospital for Sick Children, Toronto, Canada
2
Department of Otolaryngology, Head & Neck Surgery, Hospital for Sick Children, Toronto, Canada
3
Archie’s Cochlear Implant Laboratory, Hospital for Sick Children, Toronto, Canada
4
Department of Otolaryngology, Head & Neck Surgery, University of Toronto, Toronto, Canada
5
Institute of Medical Sciences, University of Toronto, Toronto, Canada
6
Hospital for Sick Children, 6103C Burton Wing, 555 University of Toronto, Toronto, Ontario M5G1X8, Canada
dates back well prior to the advent of cochlear implantation (CI). For many clinicians and researchers, the considerations of the impact of vestibular impairment in children with SNHL did not surface until the early 2000s when we clinically began to consider bilateral CI. One concern that arose at the time was the potential risk of inducing a bilateral vestibular loss (BVL) through injury in patients receiving bilateral CI. This concern provided the impetus for many of us to study what was already known about the vestibular system of children with SNHL and to add to that knowledge by more thoroughly examining children in our CI programs. Indeed, there is a risk of ves
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