Eight years of vestibular screening in children at increased risk: Results and perspectives

Since vestibular hypofunction (VH) in children can affect motor and cognitive development, standardized vestibular screening is recommended for high-risk children. However, clinical evidence on screening outcomes remains limited. This study aimed to evaluate eight years of vestibular screening results and to investigate variations across different underlying conditions.

A retrospective chart review was performed, including 229 children (aged 0-18 years) who underwent vestibular screening between 2017 and 2024. Screening indications included congenital cytomegalovirus infection (cCMV), sensorineural hearing loss (SNHL) of various etiologies and audiovestibular syndromes. VH was defined as at least one abnormal vestibular test.

VH was identified in 20.9% of screened patients. Children with hearing loss showed a higher prevalence of hypofunction (26.8%) than those without hearing loss (11.1%). The highest rates of abnormal vestibular tests were observed in children with a history of meningitis with SNHL (75.0%), followed by audiovestibular syndromes (52.2%), inner ear malformations without genetic cause (29.2%), cCMV (18.6%), and SNHL of unknown etiology (13.0%). No abnormalities were detected in children with genetic non-syndromic SNHL. Severity of hearing loss predicted vestibular hypofunction, with the highest risk in children with severe and profound hearing loss (Odds ratio: 1.348). Discordant results between cVEMP and vHIT were observed in 48.4% of children, with 80.0% showing an isolated VOR dysfunction.

This study provides a comprehensive overview of vestibular screening outcomes in a clinical setting. The findings highlight the importance of vestibular screening in high-risk children and identify specific subgroups requiring further targeted research to optimize screening protocols.