Vestibular Imaging and Function in Patients With Inner Ear Malformation Presenting With Profound Hearing Loss

Alexander Edward S Dy; Akinori Kashio; Chisato Fujimoto; Makoto Kinoshita; Yayoi S Kikkawa; Yujiro Hoshi; Kazunori Igarashi; Tsukasa Uranaka; Shinichi Iwasaki; Tatsuya Yamasoba

doi:10.1177/2473974X221128912

Vestibular Imaging and Function in Patients With Inner Ear Malformation Presenting With Profound Hearing Loss

OTO Open. 2022 Sep 26;6(3):2473974X221128912. doi: 10.1177/2473974X221128912. eCollection 2022 Jul-Sep.

Authors

Affiliations

¹ Department of Otolaryngology and Head and Neck Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan.
² Department of Otolaryngology-Head and Neck Surgery, St Luke's Medical Center, Quezon City, Philippines.
³ Department of Otolaryngology, Tokyo Teishin Hospital, Tokyo, Japan.
⁴ Department of Otolaryngology and Head and Neck Surgery, Nagoya City University, Nagoya, Japan.

Abstract

Objective: Vestibular impairment has been observed in patients with congenital hearing loss, but little is known about the vestibular anatomy and function of those in this group with inner ear malformations. This study aims to investigate the association between vestibulocochlear anatomy and vestibular function test results in children with inner ear malformations.

Study design: Case series with chart review.

Setting: Pediatric patients with inner ear malformations presenting with bilateral profound hearing loss at a tertiary hospital from 1999 to 2017.

Methods: Ears were classified into subgroups based on anatomic abnormalities seen on computed tomography imaging. Cervical vestibular evoked myogenic potential (cVEMP), rotatory chair, and caloric test results were obtained and collated. Descriptive and inferential statistics were calculated.

Results: Of 82 ears, 29.3% had incomplete partition type II malformation, the most common type. The second-most common type was isolated vestibular organ anomaly (20.7%), which is not included in currently accepted categories. Most ears exhibited abnormal vestibular function. Abnormal vestibule volume was associated with a nonreactive cVEMP (P < .001). Radiologically abnormal lateral semicircular canals were associated with abnormal caloric and rotatory chair results (P < .001).

Conclusion: With a relatively large number of cases of isolated vestibular organ anomaly not only in our study but also in previous publications, we suggest that this category be added to the subsets of inner ear malformations. Abnormal vestibule volume was significantly associated with a nonreactive cVEMP finding. The majority of patients with hearing loss secondary to inner ear malformations have abnormal vestibular function test results.

Keywords: congenital hearing loss; inner ear malformation; vestibular function.