Sensorineural Hearing Loss in Children

What are the signs and symptoms of vestibular dysfunction related to sensorineural hearing loss?

Your child’s symptoms may vary depending on whether they have vestibular dysfunction in one or both ears. It’s possible to have hearing loss in both ears but have vestibular dysfunction in only one ear. It’s also possible to have hearing loss in one ear but vestibular dysfunction in both ears. Some people may also have normal vestibular function in both ears despite having hearing loss in one or both ears. Because of these possible variations, vestibular testing with an audiologist (doctor of hearing and balance) is an important part of providing an accurate diagnosis and effective treatment.

Possible symptoms include:

• Imbalance, clumsiness or frequent falls
• Increased imbalance or clumsiness on uneven surfaces or in low light environments
• Delayed movement milestones
• Difficulty reading
• Oscillopsia (objects appear to bounce)
• Nystagmus (irregular eye movement)
• Episodic vertigo (dizziness)

Vestibular testing helps us find out if there is anything abnormal with how your child’s inner ears sense movement, how they send that information to the brain and how the brain uses that information to maintain balance. Vestibular disorders related to hearing loss are diagnosed with a vestibular evaluation.

During a vestibular evaluation, your child will undergo a series of tests that target different parts of the vestibular system. Vestibular testing can begin as early as 6 months and your child can receive more tests when they turn 3 and again when they turn 7. Vestibular testing is based on age and developmental level and could include tests such as:

• Vestibular evoked myogenic potentials (VEMPs) – This test examines how sound might affect your child’s reactions.
• Video head impulse testing (vHIT) – This test tracks eye movement and fixed focus on a single point while your child’s head moves in different directions.
• Rotational chair testing – This test records how your child’s eyes move as their body rotates from left to right.
• Videonystagmography (VNG) or electronystagmography (ENG) testing – These tests track eye movement in different ways to see how your child’s eyes react to stimuli such as sound, lights and temperature.
  • Oculomotor testing
  • Headshake testing
  • Positional/positioning testing
  • Caloric testing

What can I expect from a vestibular test?

The first step is a vestibular evaluation, which may require a referral to our Audiology Department from your child’s doctor. This evaluation varies depending on your child’s age and developmental level and will be scheduled for either 1.5 hours or 2.5 hours.

Depending on the evaluation results, we may refer your child to our Pediatric Balance and Vestibular Disorders Clinic  for a multidisciplinary exam by doctors from Otolaryngology (ENT), Audiology, Physical Therapy and Neurology. Sometimes we refer children directly to a vestibular physical therapist or neurologist without going through our Clinic.

How do we treat vestibular dysfunction related to hearing loss?

The most effective treatment for vestibular dysfunction related to hearing loss is vestibular physical therapy. This treatment can help with overall balance and dizziness symptoms. It can also help your child reach developmental milestones.

At Children’s Hospital Colorado, our vestibular audiologists work closely with our vestibular physical therapists to create a custom treatment plan based on the results from vestibular testing. The physical therapist will also check your child’s neurological, neuromuscular and musculoskeletal systems to make an individual care plan. Vestibular physical therapy is an effective way to help strengthen your child’s overall balance and help improve their quality of life.

Why choose us for treatment of vestibular dysfunction and sensorineural hearing loss?

The Pediatric Balance and Vestibular Disorders Clinic at Children’s Colorado specializes in caring for many vestibular disorders. When children complain of imbalance or dizziness, it could be the result of many different conditions. Our dedicated clinic helps diagnose and treat the full range of conditions related to these signs and symptoms.

Children’s Colorado is the only hospital in the state that has an enclosed rotary chair, necessary for assessing vestibular disorders in children with developmental differences. Without this testing, it’s difficult to completely rule out inner ear disorders in some children.

Helpful resources

The Vestibular Disorder Association (VeDA) provides education and emotional support for those with vestibular dysfunctions and advocate on behalf of all who are impacted by vestibular disorders.

Contacting us and making an appointment

Talk to your child’s doctor or managing audiologist about your concerns. We usually require a referral to both the audiology and physical therapy departments by a physician or advanced practice provider for vestibular testing and treatment.

We also want to ensure that the symptoms your child is experiencing do not require urgent medical attention. You can discuss these symptoms with one of our nurses who specialize in vestibular dysfunction and get advice by calling 720-777-8501.

We usually recommend vestibular testing to gather more information. If we recommend a vestibular evaluation, a scheduler will contact you to set up an appointment and provide additional instructions on how to prepare for the evaluation.