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Vestibular Assessment in Infants with Congenital or Early Onset Sensorineural Hearing Loss: Is Neonatal Vestibular
Lauren Farquhar1, Amr El Refaie1
1Audiology, Department of Speech and Hearing Sciences, School of Clinical Therapies, College of Medicine and Health, University College Cork, T12 AK54 Cork, Ireland.
Insights
Infants with congenital sensorineural hearing loss (SNHL) have a high risk of vestibular dysfunction (VD). Cervical vestibular-evoked myogenic potentials (cVEMP) show promise as a feasible screening tool for early detection in infants.
Area of Science:
- Pediatric Otolaryngology
- Neuroscience
- Audiology
Background:
- Congenital or early onset sensorineural hearing loss (SNHL) in infants is linked to a higher risk of vestibular dysfunction (VD).
- This association is hypothesized due to the shared embryological origins of the cochlear and vestibular systems.
- Despite the importance of early detection via Universal Newborn Hearing Screening (UNHS), vestibular assessment in infants remains understudied.
Purpose of the Study:
- To determine the prevalence of VD in infants (<12 months) with congenital or early onset SNHL.
- To identify vestibular assessment tests and protocols used in this infant population.
- To report the sensitivity and specificity of identified vestibular assessment methods.
Main Methods:
- A systematic review was conducted adhering to Joanna Briggs Institute (JBI) and PRISMA-ScR guidelines.
- Included studies focused on infants aged 0-12 months with congenital or early onset SNHL.
- Studies involving any method of vestibular assessment in these infants were analyzed.
Main Results:
- Eighteen studies were included in the review.
- Infants with congenital or early onset SNHL, especially those with bilateral severe-profound SNHL, face an elevated risk of VD.
- Cervical vestibular-evoked myogenic potentials (cVEMP) emerged as the most common vestibular assessment tool for this age group.
Conclusions:
- Findings align with existing literature on older pediatric populations.
- cVEMPs are considered a feasible, sensitive, and specific screening tool for infants with SNHL.
- The significant prevalence of VD warrants further research into establishing routine vestibular assessment pathways for infants identified through UNHS.
Background/Objectives:
Children with congenital or early onset sensorineural hearing loss (SNHL) are at a greater risk of vestibular dysfunction (VD), hypothesized to occur from the close embryological relationship between the cochlear and vestibular systems. Even with increasing focus on early detection and rehabilitation through Universal Newborn Hearing Screening (UNHS) programmes in many countries, few studies have focused on the prevalence and feasibility of vestibular assessment in infant populations. The objectives of this review are to 1. identify the prevalence of VD infants with congenital or early onset (<12 months old) SNHL, 2. identify which vestibular assessment tests/protocols are conducted on this population, 3. report sensitivity and specificity values for identified vestibular assessment tests/protocols.
Methods:
Studies that included infants aged 0-12 months, with congenital or early onset SNHL of any laterality, degree, or configuration, and who underwent any method of vestibular assessment were included. The review adhered to the Joanna Briggs Institute (JBI) guidance and the PRISMA-ScR extension statement.
Results:
A total of 18 studies were included in the review. All articles reported that infants with congenital or early onset SNHL are at a greater risk of VD, particularly those with bilateral severe-profound SNHL. The cervical vestibular-evoked myogenic potentials (cVEMP) test was the most frequently identified vestibular assessment tool for this age demographic.
Conclusions:
Results from the included articles coincide with results from literature assessing older paediatric populations. cVEMPs have been reported to be a feasible, sensitive, and specific screening tool in infants with congenital or early onset SNHL. The prevalence of VD in infants with congenital or early onset SNHL justify further investigation on the feasibility of establishing a pathway for vestibular assessment for all infants referred by UNHS programmes.
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