Maturational effects were investigated in two age groups (N = 30 per group) of children with normal hearing sensitivity, using rotary chair (RC), computerized dynamic posturography (CDP), and vestibular evoked myogenic potential (VEMP) measures. Children recruited within the younger group were three through six years of age, and children within the older group were nine through eleven years of age. Data obtained for each pediatric group were compared with clinic and/or published adult normative data for each measure. Significant age effects were seen on many CDP subtests (sensory organization test and motor control test); VEMP latencies; and RC gain, phase, and step velocity measures. The results of this study demonstrate significant maturational effects from preschool age through adulthood and suggest that adult normative data may not be appropriate when interpreting pediatric test results. Since adult techniques should oftentimes not be utilized, a proposed test battery is described that may be efficiently utilized with pediatric patients.
Eight subjects with unilateral hearing loss were fitted with wireless CROS and transcranial BTE CROS hearing aids. Results revealed that two subjects preferred the BTE transcranial CROS; four subjects preferred the wireless CROS; one subject found both hearing aid systems to be equally satisfactory; and one subject rejected both CROS fittings. In addition, a fitting strategy is introduced using probe microphone analysis to: (a) measure trans-cranial thresholds (TCT) in the unaidable ear in dB SPL measured near the eardrum, and (b) determine the sensation level of the real ear aided response (REAR-TCT) for uncorrected and corrected speech-weighted noise. The results highlight some of the difficulties associated with successfully fitting a transcranial CROS hearing aid.
lntratester test-retest reliability of the real ear unaided response (REUR) was determined on 49 ears using the Frye 6500 real ear analyzer. Results revealed mean differences of less than 1 dB for repeat measurements at seven test frequencies between 250 and 4000 Hz. The average peak resonant frequency of the repeated measure was within 16 Hz of the initial measure. In addition, the intersubject variability of the amplitude of REUR was quite large. A range of 7 dB was found at 250 to 500 Hz with the range expanding to 15 to 20 dB at 2000 to 4000 Hz. Also, the peak resonant frequency varied between 2100-4800 Hz. These results are discussed in terms of those dispensers who use the REUR to "custom" order hearing aids (Ear Hear 12 3: 216-220).
Otitis media with effusion (OME) is a common cause of vestibular disturbances in children. However, young children often lack the language to express their symptoms, and it is uncommon to screen children for vestibular impairments.The purpose of this study was to develop a screening protocol for children presenting with OME to determine if diagnostic vestibular testing is necessary.Children with normal hearing (NH), sensorineural hearing loss (SNHL), and conductive hearing loss (CHL) due to OME participated in a vestibular screening.There were 30 participants, ages four to eight years, ranging from 48 to 101 months included in the study: 10 with NH, 11 with CHL due to OME, and 9 with SNHL.The vestibular screening consists of patient and parent questionnaires and a functional evaluation. The tests examined coordination, balance, oculomotor function, and nystagmus.Those with CHL were significantly more likely to display abnormal smoothness of pursuit, as measured with observations for rapid tracking, absence of or delayed saccades, and overshoot, than those with NH or SNHL (p = 0.012). Parents of children with CHL due to OME were more likely to report their child experiencing middle ear pressure than the parents of children with NH or SNHL (p = 0.010). In addition, children with CHL were less likely to report hearing loss than those with NH or SNHL. Parent and patient report were not found to be reliable indicators of vestibular disturbances.This pilot study suggests that children with CHL due to OME present with more oculomotor abnormalities than their peers with NH. Further research is necessary to determine validity and reliability of the findings for this present study.
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