Three Years of Vestibular Infant Screening in Infants With Sensorineural Hearing Loss
Sarie Martens1, Ingeborg Dhooge2,3, Cleo Dhondt2
1Faculty of Medicine and Health Sciences, Departments of Rehabilitation Sciences, Ghent University, Ghent, Belgium.
Insights
Pediatric vestibular deficits are common in hearing-impaired infants. Severe to profound hearing loss and specific causes like meningitis significantly increase the risk of abnormal vestibular screening results.
Area of Science:
- Pediatrics
- Audiology
- Neurology
Background:
- Vestibular deficits are prevalent in hearing-impaired children, impacting development.
- Pediatric vestibular assessment is underutilized in clinical practice.
- Early detection of vestibular issues enables timely intervention.
Purpose of the Study:
- Report 3-year vestibular screening results in infants with hearing loss.
- Identify risk factors for abnormal vestibular screening results.
Main Methods:
- Implemented a basic vestibular screening test for 6-month-old infants with hearing loss in Flanders, Belgium.
- Used bone-conduction Cervical Vestibular Evoked Myogenic Potentials (cVEMP) as the screening tool.
- Included 254 infants (mean age 7.4 months) with sensorineural hearing loss from June 2018 to June 2021.
Main Results:
- 13.8% (35/254) of infants showed abnormal vestibular screening results.
- Infants with severe to profound sensorineural hearing loss had the highest risk (20.8%, OR=9.16).
- Higher prevalence of abnormal results linked to meningitis, syndromes, congenital CMV, and cochleovestibular anomalies.
Conclusions:
- Vestibular screening in infants with sensorineural hearing loss is crucial.
- Severe to profound hearing loss is a key risk factor for vestibular deficits.
- Specific etiologies like meningitis, syndromes, CMV, and cochleovestibular anomalies increase risk.
Objectives:
Although vestibular deficits are more prevalent in hearing-impaired children and can affect their development on many levels, a pediatric vestibular assessment is still uncommon in clinical practice. Since early detection may allow for timely intervention, this pioneer project has implemented a basic vestibular screening test for each six-month-old hearing-impaired infant in Flanders, Belgium. This study aims to report the vestibular screening results over a period of three years and to define the most important risk factors for abnormal vestibular screening results.
Methods:
Cervical Vestibular Evoked Myogenic Potentials with bone-conduction were used as a vestibular screening tool in all reference centers affiliated to the Universal Newborn Hearing Screening Program in Flanders. From June 2018 until June 2021, 254 infants (mean age: 7.4 months, standard deviation: 2.4 months) with sensorineural hearing loss were included.
Results:
Overall, abnormal vestibular screening results were found in 13.8% (35 of 254) of the infants. The most important group at risk for abnormal vestibular screening results were infants with unilateral or bilateral severe to profound sensorineural hearing loss (20.8%, 32 of 154) (P < .001, odds ratio = 9.16). Moreover, abnormal vestibular screening results were more prevalent in infants with hearing loss caused by meningitis (66.7%, 2 of 3), syndromes (28.6%, 8 of 28), congenital cytomegalovirus infection (20.0%, 8 of 40), and cochleovestibular anomalies (19.2%, 5 of 26).
Conclusions:
The vestibular screening results in infants with sensorineural hearing loss indicate the highest risk for vestibular deficits in severe to profound hearing loss, and certain underlying etiologies of hearing loss, such as meningitis, syndromes, congenital cytomegalovirus, and cochleovestibular anomalies.
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