An office procedure to detect vestibular loss in children with hearing impairment

As coexisting vestibular and cochlear lesions are of etiological importance, evaluation of children with congenital or early acquired hearing impairment (HI) should include vestibular assessment. A rotation test requires specific equipment and allows only detection of bilateral vestibular impairment. An impulse or head thrust test allows assessment of one ear at a time, detects more pronounced caloric side differences and can be performed without any equipment. We report a consecutive series of children with profound sensorineural HI investigated at a tertiary hospital unit. Age at taking first steps without help, the results of temporal bone images (CT/MRT) and vestibular tests were collected retrospectively from patient files. The children were 12 to 90 months old at the time they attended both a rotation and an impulse test. All 14 children cooperated in the impulse test, and 12 completed the vestibular rotation test successfully. Three out of 14 children tested so far have been confirmed to have a bilaterally pathological vestibulo-ocular reflex confirmed both in the rotation test and the impulse test. Our results show that both the rotation test and the vestibular impulse test can be successfully performed on small children at a regular outpatient appointment.