Van Hecke Ruth, Dhooge Ingeborg, Dhondt Cleo, Martens Sarie, Sucaet Marieke, Vanaudenaerde Saartje, Rombaut Lotte, De Leenheer Els, Van Hoecke Helen, Deconinck Frederik J A, Maes Leen
Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium.
Department of Otorhinolaryngology, Ghent University Hospital, Ghent, Belgium.
Ear Hear. 2025;46(5):1222-1234. doi: 10.1097/AUD.0000000000001659. Epub 2025 Apr 24.
On the basis of research and clinical experience, our otorhinolaryngology department developed an extensive protocol including auditory, vestibular, and motor assessments for all children at risk of vestibular disorders. The purpose of this study was to present the outcomes of this clinical protocol in a school-aged population and to provide an overview of the main clinical features and the motor competence of the children at risk of vestibular dysfunctions.
Data collection for this study took place between October 2017 and October 2021. During this timeframe, all school-aged children (4.0 to 16.9 years old), who were either in follow-up or referred to our otorhinolaryngology department at the Ghent University Hospital because of a risk of vestibular deficits, and who expressed a willingness to participate in the study, were included. Children were deemed at risk if they had (1) vestibular complaints (i.e., vertigo, instability, dizziness), (2) sensorineural hearing loss (with or without cochlear implant[s]), (3) a medical history with ototoxic drugs, (4) inner ear malformations defined by imaging, (5) a head trauma, (6) genetic mutations linked to vestibular loss, or (7) evidence of prior infections that are related to vestibular loss in the literature (e.g., meningitis, congenital cytomegalovirus infection).
Among the 117 participants (59 boys; 7.3 ± 3.1 years), four groups could be identified: those with combined vestibular and hearing loss (n = 47), with isolated vestibular loss (n = 5) or hearing loss (n = 33), and those without audiovestibular deficits (n = 32). Group differences revealed diminished fine motor skills, as well as lower balance and total MABC-2 scores in the group with combined vestibular and auditory dysfunctions ( p < 0.001), particularly in children with severe bilateral vestibular deficits. Moreover, the majority (38/47; 80.9%) were referred for additional monitoring of their motor functioning and/or for physical therapy.
This first large-scale study encompassing school-aged children at risk of vestibular disorders revealed a diverse clinical presentation among them. Considering crucial trends and influential factors, the study emphasized the importance of adopting a comprehensive approach, including auditory, vestibular, and motor tests, for assessing and managing pediatric vestibular concerns, particularly in children with combined vestibular and auditory deficits.
基于研究和临床经验，我们的耳鼻喉科为所有有前庭功能障碍风险的儿童制定了一项广泛的方案，包括听觉、前庭和运动评估。本研究的目的是介绍该临床方案在学龄儿童中的结果，并概述有前庭功能障碍风险儿童的主要临床特征和运动能力。
本研究的数据收集于2017年10月至2021年10月期间进行。在此期间，所有因前庭功能缺陷风险而在根特大学医院耳鼻喉科接受随访或转诊的学龄儿童（4.0至16.9岁），且表示愿意参与研究的，均被纳入。如果儿童有以下情况，则被视为有风险：（1）前庭主诉（即眩晕、不稳定、头晕），（2）感音神经性听力损失（有或无人工耳蜗），（3）有耳毒性药物病史，（4）影像学定义的内耳畸形，（5）头部外伤，（6）与前庭丧失相关的基因突变，或（7）文献中与前庭丧失相关的既往感染证据（如脑膜炎、先天性巨细胞病毒感染）。
在117名参与者（59名男孩；7.3±3.1岁）中，可以分为四组：合并前庭和听力损失的儿童（n = 47）、单纯前庭损失的儿童（n = 5）或听力损失的儿童（n = 33），以及无听觉前庭缺陷的儿童（n = 32）。组间差异显示，合并前庭和听觉功能障碍的组中，精细运动技能下降，平衡和MABC-2总分较低（p < 0.001），特别是在严重双侧前庭缺陷的儿童中。此外，大多数（38/47；80.9%）被转诊以进行额外的运动功能监测和/或物理治疗。
这项首次针对有前庭功能障碍风险的学龄儿童的大规模研究揭示了他们之间多样的临床表现。考虑到关键趋势和影响因素，该研究强调了采用综合方法（包括听觉、前庭和运动测试）来评估和管理儿童前庭问题的重要性，特别是在合并前庭和听觉缺陷的儿童中。
