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Using Functional Outcomes to Predict Vestibular Loss in Children

Kristen L Janky1, Megan LA Thomas, Jessie Patterson

  • 1Boys Town National Research Hospital, Department of Audiology, Omaha, Nebraska.

Otology & Neurotology : Official Publication of the American Otological Society, American Neurotology Society [And] European Academy of Otology and Neurotology
|November 21, 2021
PubMed

Insights

Vestibular loss severity impacts functional performance in children. The single leg stance test is an efficient predictor of vestibular loss, with horizontal canal video head impulse test gain being the strongest predictor of functional outcomes.

Area of Science:

  • Vestibular system function
  • Pediatric audiology
  • Neurology

Background:

  • Vestibular dysfunction can significantly impact a child's functional abilities.
  • Identifying reliable methods to assess vestibular loss in children is crucial for timely intervention.

Purpose of the Study:

  • To investigate the relationship between vestibular loss severity and functional performance in children.
  • To identify which functional outcomes best predict vestibular loss.
  • To determine the contribution of specific vestibular sensors (canals vs. otoliths) to functional measures.

Main Methods:

  • Prospective study at a tertiary referral center.
  • Involved 57 children with normal hearing and 55 children with cochlear implants.
  • Utilized video head impulse test (vHIT), vestibular evoked myogenic potentials (cVEMP, oVEMP), single leg stance, Standing Balance Test, dynamic visual acuity, and the Bruininks-Oseretsky Test of Motor Proficiency (BOT-2) balance subtest.

Main Results:

  • Functional performance declined with increasing vestibular loss severity, except for specific standing balance tests.
  • Single leg stance (≥5 seconds) and BOT-2 balance subtest (≥27.5 points) were highly sensitive and specific in classifying vestibular loss.
  • Average horizontal canal vHIT gain significantly predicted all functional outcomes, whereas cVEMP and oVEMP did not.

Conclusions:

  • Functional performance is directly related to vestibular loss severity in children.
  • Single leg stance is a practical and effective screening tool for vestibular loss in school-aged children.
  • Horizontal canal vHIT is the most significant predictor of functional performance, suggesting its priority in diagnostic assessments.
Abstract

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