Apeksha Kumari, Singh Sanjana, Rathnamala Monica, Varalakshmi S, Preethu D J, Kavya V, Sowndarya D S, Arpitha S, Milana K, Navya S, Thejasvi M Analey
Department of Speech and Hearing, JSS Institute of Speech and Hearing, MG Road, Mysore, India.
JSS Institute of Speech and Hearing, MG Road, Mysore, India.
Indian J Otolaryngol Head Neck Surg. 2021 Mar;73(1):12-17. doi: 10.1007/s12070-020-01797-x. Epub 2020 Jan 29.
This study aimed to assess the balance function in children with sensorineural hearing loss (SNHL) using different tests to assess vestibulospinal pathway and tests to assess vestibular system and to compare the result obtained with those of children with normal hearing sensitivity. Detailed balance assessment was done for 15 children with severe to profound SNHL and 15 children with normal hearing sensitivity in the age range of 6-10 years. The audiological evaluation included pure-tone audiometry, speech audiometry, immittance evaluation, otoacoustic emission, vestibular evoked myogenic potential (cervical VEMP and ocular VEMP), and tests to assess vestibulospinal pathway and cerebellar function, such as Romberg test, Fukuda stepping test, Tandem gait test, and Finger-to-nose test. cVEMP and oVEMP were absent in 8 ears (27%) of a total of 30 ears with SNHL. Statistical analysis shows no significant difference between latency and amplitude of cVEMP peaks and latency of oVEMP peaks across groups. Significant reduction of oVEMP peaks amplitude was seen in children with SNHL compared to children with normal hearing. Fukuda stepping test showed an abnormal response in 2 children with SNHL (13%) and one child could not perform tandem gait test (7%). Children with SNHL showed an evident abnormality on the balance assessment test results. The abnormal function of the vestibular system and the vestibulospinal pathway can compromise the child's motor development and thus needs investigation early in life.
本研究旨在通过使用不同测试来评估前庭脊髓通路以及评估前庭系统,以评估感音神经性听力损失(SNHL)儿童的平衡功能,并将所得结果与听力敏感度正常的儿童进行比较。对15名年龄在6至10岁之间的重度至极重度SNHL儿童和15名听力敏感度正常的儿童进行了详细的平衡评估。听力评估包括纯音听力测定、言语听力测定、声导抗评估、耳声发射、前庭诱发肌源性电位(颈肌前庭诱发肌源性电位和眼肌前庭诱发肌源性电位),以及评估前庭脊髓通路和小脑功能的测试,如闭目直立试验、福田踏步试验、串联步态试验和指鼻试验。在总共30只患有SNHL的耳朵中,有8只耳朵(27%)未引出颈肌前庭诱发肌源性电位和眼肌前庭诱发肌源性电位。统计分析表明,各组之间颈肌前庭诱发肌源性电位峰值的潜伏期和波幅以及眼肌前庭诱发肌源性电位峰值的潜伏期没有显著差异。与听力正常的儿童相比,患有SNHL的儿童眼肌前庭诱发肌源性电位峰值波幅明显降低。福田踏步试验显示2名患有SNHL的儿童(13%)反应异常,1名儿童无法完成串联步态试验(7%)。患有SNHL的儿童在平衡评估测试结果上表现出明显异常。前庭系统和前庭脊髓通路的功能异常会影响儿童的运动发育,因此需要在儿童早期进行调查。