Children with hearing loss have a greater risk of loss of balance

Cape Hearing Implants

Children with hearing loss have a greater risk of loss of balance

Children with hearing loss are likelier to experience vestibular loss, leading to poor balance and a range of related problems. This is a significant issue, as up to 50% of newborns with sensorineural hearing loss are thought to suffer from vestibular problems.

Vestibular dysfunction is a disorder that affects the inner ear and related structures. It is a condition in which the balance organs (vestibular system) in the inner ear do not function properly. Vestibular dysfunction can cause dizziness, vertigo, loss of balance, nausea, and motion sickness. Vestibular dysfunction can be caused by various factors such as infections, head injury, exposure to certain drugs or chemicals, and ageing. It can also occur with hearing loss, especially when the hearing loss affects the inner ear.

The inner ear contains both the hearing and balance organs. When the hearing organs are damaged, it can also affect the balance organs, leading to vestibular dysfunction. This is because the hearing and balance organs are interconnected and share some of the same structures and nerves. There are some conditions leading to hearing loss that is renowned for simultaneous vestibular loss. These include cochleovestibular malformations (inner ear developmental abnormalities), Usher syndrome, cytomegalovirus (CMV), meningitis and ototoxic medication

The loss of vestibular function can manifest in a number of ways, with poor balance and falls being the most common symptoms seen in affected children. Loss of balance can be particularly concerning in cochlear implant device failure, resulting in damage to the device due to recurrent falls. It has also been shown that children who experience cochlear implant device failure are more likely to suffer from vestibular dysfunction.

In addition to physical symptoms, vestibular dysfunction can lead to delayed motor milestones, impaired motor development, and a lack of spatial awareness. Over time, these issues can impact a child’s academic performance, leading to learning and other cognitive disabilities.

Given the potentially severe consequences of vestibular loss in children with hearing loss, screening for this type of problem is essential as early as possible. Intervention in the form of vestibular rehabilitation is often warranted, even if cochlear implantation has not yet occurred. Similar to hearing, intervention is crucial during the critical window period for developing the central pathways of the vestibular system.

Parents of children with hearing loss should be aware of the increased risk of vestibular loss and take steps to ensure that their child receives appropriate screening and intervention as needed. Early intervention can make a big difference in preventing falls, supporting healthy motor development, and promoting academic success for children with vestibular loss.

Parents must also be made aware of the impact of poor vestibular function on their child’s balance system. This understanding can help them take appropriate measures to ensure their child’s safety and well-being. Swimming, in particular, in the dark, is an activity that requires optimal balance and coordination, and poor vestibular function can increase the chances of accidents, even leading to drowning.

Cochlear implantation is a well-established procedure for individuals with severe or profound hearing loss. However, it is important to note that this procedure has a small but notable risk of vestibular loss. To minimize this risk, it is recommended that the ear with the poorest vestibular function be considered for implantation if both ears are eligible. In cases where simultaneous bilateral implantation is under consideration, the benefits of having two cochlear implants should be carefully weighed against the potential of causing bilateral vestibular loss. As such, caution and informed decision-making are crucial in ensuring the best possible outcomes for patients considering cochlear implantation.


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