Karpeta Niki, Karltorp Eva, Verrecchia Luca, Duan Maoli
Department of Clinical Science, Intervention and Technology, Karolinska Institute, 141 86 Stockholm, Sweden.
Department of Otolaryngology Head and Neck Surgery & Audiology and Neurotology, Karolinska University Hospital, 141 86 Stockholm, Sweden.
Audiol Res. 2025 Apr 13;15(2):42. doi: 10.3390/audiolres15020042.
Vestibular function implements head position regulation and body spatial navigation. It matures during childhood and adolescence and integrates with the completion of an individual's motor development. Nevertheless, vestibular impairment is associated with profound paediatric hearing loss and has a negative impact on the child's motor proficiency. Cochlear implantation (CI) is the treatment of choice for severe hearing loss, where conservative treatment plans are not appropriate or fail. The Teenager and Young Adults Cochlear Implant (TAYACI) study investigates the long-term outcomes of early implantation with respect to the hearing, speech, psychological, and balance development among CI users.
This study focuses on the vestibular function and the appropriate methods for vestibular assessment. The results of two established vestibular test methods are explored: the video head impulse test (vHIT) and cervical/ocular vestibular-evoked myogenic potentials (cVEMP, oVEMP) with air and bone conduction vibration stimulation. The results of vHIT, cVEMP, and oVEMP, per implanted ear and the relation to the aetiology of hearing loss are reported. An additional dynamic visual acuity (DVA) test was included to assess clinical oscillopsia.
Overall abnormal lateral canal testing was detected in 35/76 (46.1%) of the implanted ears. Bone-conducted cVEMP (BC cVEMP) was pathological in 33/76 (43.3%) and BC oVEMP in 42/76 (55.3%). Lateral canal impairment was associated with the background diagnosis of the hearing loss. Oscillopsia was related to bilateral canal impairment (sensitivity 73% specificity 100%).
Lateral canal testing together with BC VEMPs were the most reproducible modules for vestibular testing The above tests were related to each other and complemented the overall vestibular assessment. DVA is a helpful tool to screen dynamic oscillopsia in patients with bilateral vestibular impairment.
前庭功能负责头部位置调节和身体空间导航。它在儿童期和青少年期成熟，并与个体运动发育的完成相结合。然而，前庭功能障碍与儿童严重听力损失相关，并对儿童的运动能力产生负面影响。人工耳蜗植入（CI）是重度听力损失的首选治疗方法，适用于保守治疗方案不合适或无效的情况。青少年和青年人工耳蜗植入（TAYACI）研究调查了早期植入在人工耳蜗使用者听力、言语、心理和平衡发育方面的长期结果。
本研究聚焦于前庭功能及前庭评估的合适方法。探讨了两种既定前庭测试方法的结果：视频头脉冲测试（vHIT）以及采用气导和骨导振动刺激的颈/眼前庭诱发肌源性电位（cVEMP、oVEMP）。报告了每只植入耳的vHIT、cVEMP和oVEMP结果以及与听力损失病因的关系。还纳入了一项额外的动态视力（DVA）测试以评估临床视振荡。
在76只植入耳中的35只（46.1%）检测到总体水平半规管测试异常。骨导cVEMP（BC cVEMP）在33/76（43.3%）中呈病理性，骨导oVEMP在42/76（55.3%）中呈病理性。水平半规管损伤与听力损失的背景诊断相关。视振荡与双侧半规管损伤有关（敏感性73%，特异性100%）。
水平半规管测试与骨导VEMPs是前庭测试中最具可重复性的模块。上述测试相互关联，完善了整体前庭评估。DVA是筛查双侧前庭功能障碍患者动态视振荡的有用工具。
