Assessment of saccular function in children with sensorineural hearing loss

Guangwei Zhou, Margaret A Kenna, Katelyn Stevens, Greg Licameli
Archives of Otolaryngology—Head & Neck Surgery 2009, 135 (1): 40-4

OBJECTIVE: To investigate saccular function using vestibular evoked myogenic potentials in children with congenital or early acquired sensorineural hearing loss.

DESIGN: Retrospective cohort study.

SETTING: Pediatric tertiary referral center.

PATIENTS: Twenty-three children with bilateral sensorineural hearing loss (severe to profound in 22 cases, moderate in 1 case) underwent evaluation of saccular function. Twelve pediatric subjects with normal hearing were included in the study as the control group.

INTERVENTIONS: Otologic examination, computed tomography of the temporal bone, audiometry, tympanometry, and vestibular evoked myogenic potential testing.

MAIN OUTCOME MEASURE: Differences in threshold, amplitude, and P1 and N1 latencies of vestibular evoked myogenic potentials between children with normal-hearing and hearing-impaired children.

RESULTS: Abnormal vestibular evoked myogenic potentials were found in 21 of 23 children (91%) with sensorineural hearing loss. The thresholds of vestibular evoked myogenic potential were significantly higher (P <.001) and the amplitudes were lower in children with sensorineural hearing loss than those in children with normal hearing. There were no differences in the P1 and N1 latencies between the 2 groups.

CONCLUSIONS: The impairment of saccular function, indicated by the abnormal findings in the vestibular evoked myogenic potential, is often associated with sensorineural hearing loss in the pediatric population. Although saccular dysfunction may create a vestibular deficit, its manifestations can vary and be easily overlooked in children. Considering the high percentage of abnormal findings in our study, we recommend that deaf and hard-of-hearing children undergo vestibular evaluation. Vestibular evoked myogenic potential testing is an easy and reliable procedure to evaluate saccular function in children.

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