Paediatric vestibular assessment in French cochlear implant centres: Challenges and improvement areas

Area of Science:

• Otolaryngology
• Pediatric Audiology
• Neuroscience

Background:

• Paediatric cochlear implantation (CI) requires comprehensive vestibular assessment.
• Current practices in French CI centres are heterogeneous.
• There is a need to evaluate the current state of paediatric vestibular activity in CI centres.

Purpose of the Study:

• To survey paediatric vestibular activity across all 30 French CI centres.
• To identify challenges and areas for improvement in paediatric vestibular assessment and management.
• To compare practices regarding equipment, clinical situations, and age ranges.

Main Methods:

• A 29-question survey was distributed to all 30 French paediatric CI centres.
• The questionnaire covered vestibular activity, equipment, and management protocols.
• Data was collected on clinical situations like pre-CI assessment and vertigo management.

Main Results:

• Eighteen centres had dedicated paediatric vestibular clinics; 12 did not.
• Minimum testing age varied, with some centres starting at 3 years.
• Caloric tests, video Head Impulse Test (vHIT), rotating chair, and VEMP were common, but usage was heterogeneous.
• Expert centres utilized vHIT and cervical VEMP for infants, while dizziness assessment in older children involved multiple tests.
• Ocular VEMP was rarely employed.

Conclusions:

• Paediatric vestibular assessment demands specialized expertise distinct from adult protocols.
• Shortages in specialized personnel may prevent some centres from meeting French CI guidelines.
• International recommendations and public health policies are crucial for standardizing paediatric vestibular management, training, and access.