Vestibular And Radiological Evaluation Of Hearing Impaired Children With Delayed Motor Development | 107647
Otolaryngology: Open Access
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Vestibular and radiological evaluation of hearing impaired children with delayed Motor development
Joint Event on 4th European Otolaryngology-ENT Surgery Conference & 3rd International Conference on Craniofacial Surgery
Mohamed El-Moursy kasem, Mohamed Salama Bakr, Samy Abd-Elaziz Sayed, Enass Sayed Mohamed, Mostafa Ahmed Aly Youssif
Audiovestibular medicine Unit, Al-Azher University Hospital (Assiut) , EgyptAudiovestibular medicine Unit, Assiut University Hospital, EgyptRadiology Department , Assiut University Hospital, EgyptAudiovestibular medicine Unit, Sohag University Hospital, Egypt
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.
Dr. Mohammed Elmoursy Kasem presently works at Assiut College of Medicine at Al-Azhar university, Egypt. He completed his Doctorate in Department of Audiology in Assiut University. He perform different vestibular rehabilitation exercise.