Author/Authors :
Elmoursy, Mohamed Audiovestibular medicine Unit - Al-Azher University Hospital - Assiut - Egypt , Salama Bakr, Mohamed ENT Department - Assuit university - Egypt , Abdelaziz Sayed, Samy Radiology Deptartment - Assiut University Hospital - Egypt , Ahmed Ali, Mostafa Audiovestibular medicine Unit - Sohag University Hospital - Egypt , Sayed Mohamed, Enass ENT Department - Al-Azher university - Assuit - Egypt
Abstract :
Background: Combined hearing and vestibular loss in children pose potentially significant problems. Children and
infants with vestibular problems are faced with motor problems that could limit their normal development.
Objectives: the aim of the study is to assess the relationship between the vestibular disorders and the delayed motor
development in hearing impaired children as well as to assess the integrity of the vestibular system through clinical testing
and radiological imaging in those children with delayed motor development.
Methods: Thirty hearing impaired children with history of delayed motor milestones, and a control group of 10 hearing
impaired children with normal motor development were included with variable degree of hearing loss. Each child was
subjected to careful history taking, general examination, otoscopic examination, motor and balance questionnaires were
answered by the parents or caregivers, audiological evaluation either through conditioned play audiometry or conventional
audiometry, speech audiometry and Immittancemetry. Vestibular evaluation through cVEMP and caloric tests and finally
the radiological studies through CT and MRI of the petrous bone.
Results: There were variable degrees of hearing loss among both groups. In the control group (10 HI children, 20 ears),
18 ears (90%) had VEMP response, while two ears (10%) had absent VEMP, while in the study group (30 HI children,
60 ears), 48 ears (80%) had VEMP response, while 12 ears (20%) had absent VEMP. All children in the control group
had normal caloric response, while in the study group, 23 children (77%) had normal response, and seven children (23%)
had abnormal caloric response, 4 children had bilateral weakness and 3 had unilateral weakness. CT and MRI study of
petrous bone was done for the control group and revealed normal radiology, while in the study group, 21 children had
normal imaging (70%) and the last 9 children (30%) had abnormal findings, the most common abnormalities was enlarged
vestibular aqueduct (13%), followed by common cavity (7%).
Conclusion: Children with hearing loss, irrespective of the degree of hearing loss, the vestibular system should be
screened, assessed as it may be responsible for co-morbidities in fine and gross motor difficulties. Early intervention and effective therapy will be the proper way to get good outcome.
Keywords :
delayed motor function , hearing impaired children , radiological evaluation , vestibular
