Clinical balance tests for evaluation of balance dysfunction in children with sensorineural hearing loss

Abstract Aim: Children with hearing impairment may have a potential risk for vestibular dysfunctions. They may undergo a sensory redistribution process whereby visual and somatosensory information becomes more essential for postural control. The aim of the study was to assess the balance ability in children with sensorineural hearing loss (SNHL) compared with normal-hearing controls using clinical balance subset tests. A second aim was to determine the prognostic value of some etiological, audiological, and demographic (age and sex) factors in predicting a possibility for vestibular impairment for the early identification of children with vestibular deficits. Participants and methods: Thirty children with normal hearing (17 girls and 13 boys) and 50 children with bilateral SNHL of varying degree, aged between 5 and 15 years, were recruited from the Audiology Unit of Assiut University Hospital. All of them were subjected to the following: basic audiological evaluation (pure tone, speech audiometry), immittancemetry and auditory brainstem responses, clinical balance subset tests of the standardized Bruininks-Oseretsky Test of motor proficiency (BOT-2), modified Clinical Test of Sensory Interaction for Balance (mCTSIB), one-leg stand (OLS), and tandem stand. Results: Hearing-impaired (HI) children showed bilateral SNHL of varying degree, ranging from moderate to profound hearing loss (moderately–severe 32%, severe 18%, and profound 50%) and of different etiologies (heredofamilial 46%, acquired 38%, not known 16%). Balance abilities as measured in this study were significantly poorer in HI children compared with normal-hearing children. HI children with acquired cause and profound degree of SNHL had the highest abnormal score in these clinical tests compared children with other etiologies and degrees of SNHL (although this difference did not reach statistical significance). In most clinical balance tests that were done in this study, the youngest children in the HI group achieved scores that were almost lower than the scores obtained by the older age groups; the most significant difference was observed for tests performed with eyes closed. Conclusion: Balance dysfunction occurs in a significant percentage of HI children and may have significant detrimental effects on motor development mainly in very young children. Therefore, information on the identification and treatment of these balance dysfunctions is crucial. © 2013, The Egyptian Oto - Rhino - Laryngological Society.