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Vestibular Impairment and Postural Development in Children With Bilateral Profound Hearing Loss
Sylvette R Wiener-Vacher1,2, Marta Campi1, Simona Caldani1,2
1Institut de l'Audition, Institut Pasteur, Centre De Recherche et d'Innovation et Audiologie Humaine (CERIAH), Paris, France.
JAMA Network Open
|May 23, 2024
Summary
Vestibular impairment is common in children with profound hearing loss (HL), particularly those with genetic or CMV-related causes. This impairment is linked to delayed motor development, highlighting the need for vestibular assessment before cochlear implantation.
Area of Science:
- Pediatric audiology
- Neuroscience
- Developmental pediatrics
Background:
- Profound hearing loss (HL) in children can impact cochlear implant outcomes, especially when accompanied by vestibular impairment.
- Vestibular function assessment is not routinely used alongside audiologic testing for cochlear implantation decisions.
Purpose of the Study:
- To determine the prevalence of vestibular impairment in children with profound HL, categorized by the origin of their hearing loss.
- To investigate the association between vestibular impairment and delayed posturomotor development in this population.
Main Methods:
- A cohort study analyzed medical records of 592 children with profound HL undergoing cochlear implantation.
- Children were grouped by vestibular function: normal (NVF), partially impaired (PVF), and complete bilateral loss (CBVL).
- Statistical models assessed the link between HL origin, vestibular impairment, and developmental milestone achievement.
Main Results:
- Vestibular impairment was found in 44.4% of children, with higher prevalence in those with genetic syndromic HL (78.3%) and CMV infection (69.2%).
- Children with partially impaired or complete bilateral vestibular loss showed significantly higher odds of delayed motor development milestones.
- The severity of vestibular impairment correlated with the delay in achieving milestones like head holding and walking.
Conclusions:
- Vestibular impairment is prevalent in children with profound HL and is associated with delayed motor development.
- HL origin influences vestibular impairment, with genetic and CMV-related causes showing higher rates.
- Comprehensive vestibular assessment before cochlear implantation is recommended to guide early, tailored interventions.
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