Faculty of Medicine and Health Sciences, Departments of Rehabilitation Sciences, Ghent University, Ghent, Belgium.
Faculty of Medicine and Health Sciences, Department of Head and Skin, Ghent University, Ghent, Belgium.
Pediatrics. 2022 Jul 1;150(1). doi: 10.1542/peds.2021-055340.
Although vestibular deficits are more prevalent in hearing-impaired children and can affect their development on many levels, a pediatric vestibular assessment is still uncommon in clinical practice. Since early detection may allow for timely intervention, this pioneer project has implemented a basic vestibular screening test for each six-month-old hearing-impaired infant in Flanders, Belgium. This study aims to report the vestibular screening results over a period of three years and to define the most important risk factors for abnormal vestibular screening results.
Cervical Vestibular Evoked Myogenic Potentials with bone-conduction were used as a vestibular screening tool in all reference centers affiliated to the Universal Newborn Hearing Screening Program in Flanders. From June 2018 until June 2021, 254 infants (mean age: 7.4 months, standard deviation: 2.4 months) with sensorineural hearing loss were included.
Overall, abnormal vestibular screening results were found in 13.8% (35 of 254) of the infants. The most important group at risk for abnormal vestibular screening results were infants with unilateral or bilateral severe to profound sensorineural hearing loss (20.8%, 32 of 154) (P < .001, odds ratio = 9.16). Moreover, abnormal vestibular screening results were more prevalent in infants with hearing loss caused by meningitis (66.7%, 2 of 3), syndromes (28.6%, 8 of 28), congenital cytomegalovirus infection (20.0%, 8 of 40), and cochleovestibular anomalies (19.2%, 5 of 26).
The vestibular screening results in infants with sensorineural hearing loss indicate the highest risk for vestibular deficits in severe to profound hearing loss, and certain underlying etiologies of hearing loss, such as meningitis, syndromes, congenital cytomegalovirus, and cochleovestibular anomalies.
尽管前庭功能障碍在听力受损儿童中更为常见，并且可能在多个层面上影响他们的发育，但儿科前庭评估在临床实践中仍然不常见。由于早期发现可能允许及时干预，因此这个开创性项目为比利时佛兰德斯的每一个六个月大的听力受损婴儿实施了基本的前庭筛查测试。本研究旨在报告三年期间的前庭筛查结果，并确定异常前庭筛查结果的最重要危险因素。
在佛兰德斯的所有隶属于普遍新生儿听力筛查计划的参考中心，都使用经骨传导的颈性前庭诱发肌源性电位作为前庭筛查工具。从 2018 年 6 月至 2021 年 6 月，共纳入 254 名（平均年龄：7.4 个月，标准差：2.4 个月）患有感觉神经性听力损失的婴儿。
总体而言，13.8%（254 名中的 35 名）的婴儿出现异常前庭筛查结果。最有可能出现异常前庭筛查结果的重要风险群体是单侧或双侧重度至极重度感觉神经性听力损失的婴儿（20.8%，154 名中的 32 名）（P<0.001，优势比=9.16）。此外，脑膜炎（66.7%，3 名中的 2 名）、综合征（28.6%，28 名中的 8 名）、先天性巨细胞病毒感染（20.0%，40 名中的 8 名）和耳蜗前庭异常（19.2%，26 名中的 5 名）引起听力损失的婴儿中，异常前庭筛查结果更为普遍。
感觉神经性听力损失婴儿的前庭筛查结果表明，在重度至极重度听力损失中，前庭功能障碍的风险最高，而某些听力损失的潜在病因，如脑膜炎、综合征、先天性巨细胞病毒和耳蜗前庭异常。
