Objective: To evaluate the function of the superior and inferior vestibular nerve systems in children with profound sensorineural hearing loss, and to assess the influence of dysfunction of each vestibular nerve system on the development of gross motor function. Study Design: Retrospective study. Setting: A tertiary referral center. Methods: Eighty-nine children (age range: 20–97 months) with profound sensorineural hearing loss who were due to undergo cochlear implant surgery were recruited. Function of the superior vestibular nerve system was evaluated by the damped rotation test and the caloric test, whereas functions of the inferior vestibular nerve systems were evaluated by the vestibular evoked myogenic potential (VEMP) test. Gross motor development was assessed using the age of acquisition of head control and independent walking. Results: Among the children able to complete the vestibular function tests, abnormalities were found in 20% (16 of 84 children) in the damped rotation test, 41% (31 of 75 children) in the caloric test and 42% (26 of 62 children) in the VEMP test. Children who showed abnormal responses in the vestibular function tests showed significantly delayed acquisition of head control (p < 0.05) and independent walking (p < 0.05) in comparison with children with normal responses. The children who showed abnormal responses in all 3 vestibular tests showed the greatest delay in acquisition of gross motor function in comparison with the other groups. Conclusions: Children with profound hearing loss tend to have dysfunction in the superior as well as the inferior vestibular nerve systems. Both the superior and inferior vestibular nerve systems are important for the development of gross motor function in children.

Keywords:
Vestibular evoked myogenic potential, Caloric test, Rotational test, Gross motor development
1.
Assaiante C, Amblard B: Peripheral vision and age-related differences in dynamic balance. Hum Mov Sci 1992;11:533–548.
2.
Berger W, Quintern J, Dietz V: Afferent and efferent control of stance and gait: developmental changes in children. Electroencephalogr Clin Neurophysiol 1987;66:244–252.
3.
Buchman CA, Joy J, Hodges A, Telischi FF, Balkany TJ: Vestibular effects of cochlear implantation. Laryngoscope 2004;114:1–22.
4.
Butterfield SA: Gross motor profiles of deaf children. Percept Mot Skills 1986;62:68–70.
5.
Colebatch JG, Halmagyi GM: Vestibular evoked potentials in human neck muscles before and after unilateral vestibular deafferentation. Neurology 1992;42:1635–1636.
6.
Crowe TK, Horak FB: Motor proficiency associated with vestibular deficits in children with hearing impairments. Phys Ther 1988;68:1493–1499.
7.
Cushing SL, Chia R, James AL, Papsin BC, Gordon KA: A test of static and dynamic balance function in children with cochlear implants: the vestibular Olympics. Arch Otolaryngol Head Neck Surg 2008a;134:34–38.
8.
Cushing SL, Papsin BC, Rutka JA, James AL, Gordon KA: Evidence of vestibular and balance dysfunction in children with profound sensorineural hearing loss using cochlear implants. Laryngoscope 2008b;118:1814–1823.
9.
Diepeveen JE, Jensen J: Differential caloric reactions in deaf children. Acta Otolaryngol 1968;65:570–574.
10.
Enbom H, Magnusson M, Pyykko I: Postural compensation in children with congenital or early acquired bilateral vestibular loss. Ann Otol Rhinol Laryngol 1991;100:472–478.
11.
Eviatar L, Miranda S, Eviatar A, Freeman K, Borkowski M: Development of nystagmus in response to vestibular stimulation in infants. Ann Neurol 1979;5:508–514.
12.
Iwasaki S, Takai Y, Ito K, Murofushi T: Abnormal vestibular evoked myogenic potentials in the presence of normal caloric responses. Otol Neurotol 2005;26:1196–1199.
13.
Jacot E, van den Abbeele T, Debre HR, Wiener-Vacher SR: Vestibular impairments pre- and post-cochlear implant in children. Int J Pediatr Otorhinolaryngol 2009;73:209–217.
14.
Jin Y, Nakamura M, Shinjo Y, Kaga K: Vestibular-evoked myogenic potentials in cochlear implant children. Acta Otolaryngol 2006;126:164–169.
15.
Kaga K: Vestibular compensation in infants and children with congenital and acquired vestibular loss in both ears. Int J Pediatr Otorhinolaryngol 1999;49:215–224.
16.
Kaga K, Shinjo Y, Jin Y, Takegoshi H: Vestibular failure in children with congenital deafness. Int J Audiol 2008;47:590–599.
17.
Kaga K, Suzuki JI, Marsh RR, Tanaka Y: Influence of labyrinthine hypoactivity on gross motor development of infants. Ann NY Acad Sci 1981;374:412–420.
18.
Kelsch TA, Schaefer LA, Esquivel CR: Vestibular evoked myogenic potentials in young children: test parameters and normative data. Laryngoscope 2006;116:895–900.
19.
McCue MP, Guinan JJ: Acoustically responsive fibers in the vestibular nerve of the cat. J Neurosci 1994;14:6058–6070.
20.
Murofushi T, Curthoys IS, Topple AN, Colebatch JG, Halmagyi GM: Responses of guinea pig primary vestibular neurons to clicks. Exp Brain Res 1995;103:174–178.
21.
Murofushi T, Halmagyi GM, Yavor RA, Colebatch JG: Absent vestibular evoked myogenic potentials in vestibular neurolabyrinthitis. An indicator of inferior vestibular nerve involvement? Arch Otolaryngol Head Neck Surg 1996;122:845–848.
22.
Murofushi T, Matsuzaki M, Mizuno M: Vestibular evoked myogenic potentials in patients with acoustic neuromas. Arch Otolaryngol Head Neck Surg 1998;124:509–512.
23.
Murofushi T, Matsuzaki M, Wu CH: Short tone burst-evoked myogenic potentials on the sternocleidomastoid muscle: are these potentials also of vestibular origin? Arch Otolaryngol Head Neck Surg 1999;125:660–664.
24.
Potter CN, Silverman LN: Characteristics of vestibular function and static balance skills in deaf children. Phys Ther 1984;64:1071–1075.
25.
Rine RM, Cornwall G, Gan K, LoCascio C, O’Hare T, Robinson E, Rice M: Evidence of progressive delay of motor development in children with sensorineural hearing loss and concurrent vestibular dysfunction. Percept Mot Skills 2000;90:1101–1112.
26.
Sennaroglu L, Saatci I: A new classification for cochleovestibular malformations. Laryngoscope 2002;112:2230–2241.
27.
Sheykholeslami K, Megerian CA, Arnold JE, Kaga K: Vestibular-evoked myogenic potentials in infancy and early childhood. Laryngoscope 2005;115:1440–1444.
28.
Shinjo Y, Jin Y, Kaga K: Assessment of vestibular function of infants and children with congenital and acquired deafness using the ice-water caloric test, rotational chair test and vestibular-evoked myogenic potential recording. Acta Otolaryngol 2007;127:736–747.
29.
Suarez H, Angeli S, Suarez A, Rosales B, Carrera X, Alonso R: Balance sensory organization in children with profound hearing loss and cochlear implants. Int J Pediatr Otorhinolaryngol 2007;71:629–637.
30.
Todt I, Hennies HC, Basta D, Ernst A: Vestibular dysfunction of patients with mutations of connexin 26. Neuroreport 2005;16:1179–1181.
31.
Tribukait A, Brantberg K, Bergenius J: Function of semicircular canals, utricle and saccules in deaf children. Acta Otolaryngol 2004;124:41–48.
32.
Tsukada K, Nishio S, Usami S, Deafness Gene Study Consortium: A large cohort study of GJB2 mutations in Japanese hearing loss patients. Clin Genet 2010;78:464–470.
33.
Viciana D, Lopez-Escamez JA: Short tone bursts are better than clicks for cervical vestibular-evoked myogenic potentials in clinical practice. Eur Arch Otorhinolaryngol 2012;269:1857–1863.
34.
Wallacott MH, Assaiante C, Amblard B: Development of balance and gait control; in Bronstein AM, Brandt T, Wallacott MH, Nutt JG (eds): Clinical Disorders of Balance, Posture and Gait, ed 2. London, Arnold, 2004, pp 39–62.
35.
Welgampola MS, Colebatch JG: Characteristics and clinical applications of vestibular-evoked myogenic potentials. Neurology 2005;64:1682–1688.
36.
Zagólski O: Vestibular-evoked myogenic potentials and caloric stimulation in infants with congenital cytomegalovirus infection. J Laryngol Otol 2008;122:574–579.
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2013
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