Objective and Subjective Assessment of Central and Peripheral Imbalance in Children With Cochlear Implants

Sunday, September 29, 2024

2:36 PM – 2:42 PM EDT

Location: MBCC, 225

Disclosure(s):

Mariana Ribeiro Cardoso Oliveira:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: It is currently known that severe-to-profound Sensorineural Hearing Loss (STP SNHL), in children with or without cochlear implantation (CI), is sometimes associated with balance disturbances. Our objective is to quantify subjective and objective vestibular and neurological assessment in pre scholar children with CI.

Methods: Retrospective cohort study of children with STP SNHL submitted to CI in a tertiary pediatric cochlear implant referral center, at preschooler age (0-6 years). For vestibular assessment (VA) we considered clinical vestibular exam (CVE) (Head Impulse Test, Romberg on an unstable surface, single-leg standing, squat, and gait) and cervical vestibular-evoked myogenic potentials (cVEMP). Neurological assessment (NA) was performed by a pediatric neurologist and included motor milestones, behavioral and socio-emotional disorders, and fine motor skills. Inner ear and brain imaging was also obtained.

Results: From 122 children submitted to CI at preschooler age, 76 were submitted to preoperative cVEMP (55% abnormal) and 78 preoperative CVE (58% abnormal). Of those, 58 children had a complete VA, whose SNHL etiologies were 31% idiopathic (50% abnormal cVEMP and 44% abnormal CVE), 26% cytomegalovirus (80% abnormal cVEMP and 60% abnormal CVE), 24% genetic non-syndromic (29% abnormal cVEMP and 43% abnormal CVE), 12% genetic syndromic (43% abnormal cVEMP and 86% abnormal CVE), 5% meningitis (67% abnormal cVEMP and 100% abnormal CVE), and 2% other causes. There were 21 children with CI that had both pre and postoperative VA and NA. Most (64%) had abnormal VA (47% abnormal CVE and 42% abnormal cVEMP), 19% improve on VA, 76% maintained, and 5% got worse. NA was abnormal, in different degrees, in 43% and 29% had abnormal brain imaging.

Conclusions: Vestibular and neurological abnormalities were prevalent in our cohort and should be screened in children with SNHL. CI may improve vestibular status, also further studies are need.

Presenting Author(s)

Mariana Ribeiro Cardoso de Oliveira

Resident
Unidade Local de Saúde São José- Lisboa
Lisboa, Lisboa, Portugal

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Co-Author(s)

EV

Eulália Viveiros, MD

Centro Hospitalar Universitário Lisboa Central, United States

Disclosure information not submitted.
MM

Marta Mariano

Disclosure information not submitted.
TV

Tiago Velada, MD

Centro Hospitalar Universitário Lisboa Central, United States

Disclosure information not submitted.
AR

Alexandra Rodrigues, MD

Centro Hospitalar Universitário Lisboa Central, United States

Disclosure information not submitted.

Senior Author(s)

RS

Rita Silva, MD

Centro Hospitalar Universitário Lisboa Central, United States

Disclosure information not submitted.
PM

Patrícia Melo, MD

Centro Hospitalar Universitário Lisboa Central, United States

Disclosure information not submitted.
IA

Inês Alpoim Moreira, MD

Centro Hospitalar Universitário Lisboa Central, United States

Disclosure information not submitted.
HS

Herédio Sousa, MD

Chief
CHULC
Lisbon, Lisboa, Portugal

Disclosure information not submitted.