Selz P A, Girardi M, Konrad H R, Hughes L F
Division of Otolaryngology, Department of Surgery, Southern Illinois University School of Medicine, Springfield, 62794-9230, USA.
Otolaryngol Head Neck Surg. 1996 Jul;115(1):70-7. doi: 10.1016/S0194-5998(96)70139-0.
Considerable knowledge has been accumulated regarding acquired and congenital deafness in children. However, despite the intimate relationship between the auditory and vestibular systems, data are limited regarding the status of the balance system in these children. Using a test population of 15 children, aged 8 to 17 years, we performed electronystagmography testing. The test battery consisted of the eye-tracking (gaze nystagmus, spontaneous nystagmus, saccade, horizontal pursuit and optokinetic) tests, positional/positioning (Dix-Hallpike and supine) tests, and rotational chair tests. With age-matched controls, five children were tested in each of the following three categories: normal hearing, hereditary deafness, and acquired deafness. The children in the hereditary deafness category were congenitally deaf and had a family history of deafness. Those subjects in the acquired deafness category had hearing loss before the age of 2 years, after meningitis. Analysis of variance demonstrated significant differences between the two deaf groups and the control subjects in the gaze nystagmus test, saccade latencies, horizontal pursuit phase, and Dix-Hallpike and supine positionally provoked nystagmus. Also, significant differences were found in rotational chair gain and phase between the deaf and normal-hearing children. The children with acquired deafness exhibited the most profound results. In addition, there were significant differences in rotational chair gain between the acquired and congenitally deaf children. No differences were noted in horizontal pursuit gains, saccade accuracies, or saccade asymmetries. These preliminary data demonstrate that the etiologic factors responsible for congenital and acquired deafness in children may indeed affect the balance system as well. These findings of possible balance disorders in conjunction with the profound hearing loss in this patient population will have prognostic implications in the future evaluation, treatment, and rehabilitation of these patients.
关于儿童获得性和先天性耳聋，人们已经积累了相当多的知识。然而，尽管听觉和前庭系统之间关系密切，但关于这些儿童平衡系统状况的数据却很有限。我们以15名8至17岁的儿童为测试对象，进行了眼震电图测试。测试项目包括眼动追踪（凝视性眼震、自发性眼震、扫视、水平跟踪和视动性眼震）测试、位置/定位（Dix-Hallpike和仰卧位）测试以及转椅测试。我们选取了年龄匹配的对照组，在以下三个类别中各测试了五名儿童：听力正常、遗传性耳聋和获得性耳聋。遗传性耳聋组的儿童为先天性耳聋且有耳聋家族史。获得性耳聋组的受试者在2岁前因脑膜炎后出现听力损失。方差分析表明，在凝视性眼震测试、扫视潜伏期、水平跟踪阶段以及Dix-Hallpike和仰卧位诱发的眼震方面，两个耳聋组与对照组之间存在显著差异。此外，耳聋儿童与听力正常儿童在转椅增益和相位方面也存在显著差异。获得性耳聋儿童的结果最为显著。此外，获得性耳聋儿童与先天性耳聋儿童在转椅增益方面也存在显著差异。在水平跟踪增益、扫视准确性或扫视不对称性方面未发现差异。这些初步数据表明，导致儿童先天性和获得性耳聋的病因因素确实可能也会影响平衡系统。这些关于可能存在平衡障碍的发现，连同该患者群体严重的听力损失，将对这些患者未来的评估、治疗和康复产生预后影响。
