Lubetzky Anat V, Kelly Jennifer L, Scigliano Katherine, Morris Brittani, Cheng Kristyn, Harel Daphna, Cosetti Maura
Department of Physical Therapy, New York University, New York.
Department of Applied Statistics, Social Science, and Humanities, New York University, New York.
Otol Neurotol. 2025 Feb 1;46(2):221-228. doi: 10.1097/MAO.0000000000004400. Epub 2024 Dec 11.
Recent studies suggest that hearing loss is associated with balance dysfunction and an increased risk of falls. The purpose of this study was to investigate whether adults with unilateral hearing loss (UHL) have an underlying vestibular dysfunction and whether vestibular testing explains balance function and fall risk.
Cross-sectional.
Urban otology practice and a human motion laboratory.
We recruited 41 healthy controls (mean age, 52 years; range, 22-78 years) and 29 adults with stable UHL (mean age, 53 years; range, 18-80 years) who denied symptoms of dizziness (Dizziness Handicap Inventory average, 1.86; range, 0-14). UHL occurred an average of 4 years (range from sudden loss, 4 months to 27.5 years) prior to testing.
We conducted the caloric portion of the videonystagmography test, video head impulse test (vHIT), and a battery of balance tests: standing on foam with eyes closed, timed up and go test, four square step test, 10-meter walk, and a virtual reality (VR) assessment of postural control.
Hearing was quantified by four-frequency pure-tone average (PTA). Caloric weakness was defined as asymmetry greater than 25%. Participants self-reported falls over the past 12 months and history of vertigo. Performance on balance tests was quantified by time to completion or duration of hold. Performance on the VR assessment was quantified by root-mean-square velocity of head sway.
Proportion of unilateral caloric weakness was significantly higher in the UHL group (25%) than the control group (12%). Five participants with UHL refused caloric testing. vHIT gains of lateral canals were normal in both groups. The majority of participants in the UHL group experienced vertigo at the onset of hearing loss (72%). There were five fallers in the UHL group (17%) and three in the control group (7%). Participants with caloric weakness or vertigo at onset did not differ from those without in age or in any of the balance tests. Participants with history of falls differed in head sway and duration of hold standing on foam with eyes closed.
Individuals with UHL are more likely to have caloric weakness than healthy controls; however, these findings are not correlated with functional outcomes or history of falls. Postural control testing using virtual reality or standing on foam with eyes closed may help detect those at a risk for falls.
近期研究表明，听力损失与平衡功能障碍及跌倒风险增加有关。本研究的目的是调查单侧听力损失（UHL）的成年人是否存在潜在的前庭功能障碍，以及前庭测试是否能解释平衡功能和跌倒风险。
横断面研究。
城市耳科诊所和人体运动实验室。
我们招募了41名健康对照者（平均年龄52岁；范围22 - 78岁）和29名单侧听力损失稳定的成年人（平均年龄53岁；范围18 - 80岁），他们否认有头晕症状（头晕残障量表平均分1.86；范围0 - 14）。单侧听力损失发生在测试前平均4年（从突然听力损失4个月到27.5年不等）。
我们进行了视频眼震电图测试的冷热试验部分、视频头脉冲试验（vHIT）以及一系列平衡测试：闭眼站在泡沫上、计时起立行走测试、四方步测试、10米步行以及姿势控制的虚拟现实（VR）评估。
听力通过四频率纯音平均（PTA）进行量化。冷热试验减弱定义为不对称性大于25%。参与者自我报告过去12个月内的跌倒情况和眩晕病史。平衡测试的表现通过完成时间或保持时间进行量化。VR评估的表现通过头部摆动的均方根速度进行量化。
单侧听力损失组单侧冷热试验减弱的比例（25%）显著高于对照组（12%）。5名单侧听力损失参与者拒绝冷热试验。两组水平半规管的视频头脉冲试验增益均正常。单侧听力损失组的大多数参与者在听力损失开始时经历过眩晕（72%）。单侧听力损失组有5名跌倒者（17%），对照组有3名（7%）。冷热试验减弱或开始时出现眩晕的参与者在年龄或任何平衡测试方面与未出现这些情况的参与者没有差异。有跌倒史的参与者在头部摆动和闭眼站在泡沫上的保持时间方面存在差异。
单侧听力损失的个体比健康对照者更有可能出现冷热试验减弱；然而，这些发现与功能结果或跌倒史无关。使用虚拟现实或闭眼站在泡沫上进行姿势控制测试可能有助于检测有跌倒风险者。
