International Pediatric Otolaryngology Group (IPOG) Consensus on Vestibular Testing in Children

Area of Science:

• Pediatric Vestibular Assessment
• Audiology and Vestibular Science

Background:

• Lack of standardized protocols for pediatric vestibular testing leads to variability in clinical practice.
• Existing approaches to assessing vestibular function in children differ significantly between expert and non-expert centers.

Purpose of the Study:

• To establish a consensus guideline for minimum pediatric vestibular tests.
• To provide recommendations for both expert and non-expert centers conducting pediatric vestibular assessments.

Main Methods:

• A modified Delphi process involving 21 international pediatric vestibular experts was utilized.
• Three rounds of expert opinion were conducted to achieve consensus.
• Consensus was defined as agreement by over 80% of participants.

Main Results:

• For non-expert teams, minimal testing includes lateral canal video head impulse testing (vHIT) with remote camera and bone conduction cervical VEMPs.
• For expert teams, testing 1-year-olds requires lateral canal vHIT and bone conduction cervical VEMPs.
• For expert teams testing 4-year-olds, minimal testing includes vHIT in all canals, cervical and ocular VEMPs (bone or air conduction), and rotary chair.

Conclusions:

• This international consensus provides a framework for comparable, age-dependent pediatric vestibular testing protocols.
• The guidelines aim to foster collaboration and establish minimal standards for new pediatric vestibular teams.
• Video head impulse testing (vHIT) and cervical VEMPs (cVEMP) in bone conduction are identified as key tests for children.