Gaze Stability in Children with Hearing and Vestibular Loss

在听力损失（CHL）的儿童中，前庭损失的存在可能导致粗大运动障碍。 发育延迟和视力下降，需要额外的阻碍。然而，前庭测试 在儿科人群中并不常见，前庭障碍很少被认为是CHL。的长期 本研究的目的是诊断CHL患者前庭功能丧失，并将其影响降至最低。作为 第一步，本提案的目标是表征CHL的前庭功能，以及 研究前庭损失对静态（头部稳定）和动态（头部运动）视力的影响， 这些孩子中心假设是静态视力（SVA）和动态视力（DVA） 在CHL中降解，伴有前庭丧失。这一假设是基于对前庭功能丧失的成年人的研究， 站立、行走和头部运动时视力下降， 日常生活这项研究的基本原理是，视力下降，特别是在课堂上， 可能会影响CHL的学术成就。我们实验室获得的初步数据表明， 减少CHL。两个具体的目标将解决在这个建议：1）我们将表征前庭损失 在CHL中，2）我们将评估前庭损失对这些儿童的SVA和DVA的影响。我们将重点 使用人工耳蜗植入体（CI）的CHL患者，由于植入导致前庭丧失的风险增加， 听力损失的病因。这提供了具有前庭丧失的CHL人群，其中视觉敏锐度可以被降低。 更好地研究。在目标1中，已经开发了一种用于评估外耳道功能的新方法， 将在儿童中进行评估。此外，前庭功能丧失的严重程度 和总运动表现进行研究。在目标2中，SVA和DVA将在坐位时进行评估， 在保持直立姿势的需求不断增加的情况下。这项工作将提供有关 CHL中前庭丧失的患病率和前庭丧失影响视力的程度。这将 进一步推进我们对CHL中前庭损失的自然补偿过程的理解，并导致 进一步研究CHL前庭丧失的识别、影响和障碍。

In children withi hiearing loss (CHL), the presence of vestibular loss may result in gross motor developmental delay and reduced visual acuity, requiring additional habilitation. However, vestibular testing is not routine in the pediatric population, and vestibular habilitation is seldom considered for CHL. The longterm goal of this research program is to diagnose and then minimize the impact of vestibular loss in CHL. As a first step, the objectives in the present proposal are to characterize vestibular function in CHL, and investigate the effect of vestibular loss on static (head stable) and dynamic (head in motion) visual acuity in these children. The central hypothesis is that both static visual acuity (SVA) and dynamic visual acuity (DVA) are degraded in CHL with vestibular loss. This hypothesis is based on research in adults with vestibular loss, who experience reduced visual acuity with standing, walking and head movement, which impairs activities of daily living. The rationale for the proposed research is that reduced visual acuity, especially in the classroom, may impair academic success in CHL. Preliminary data obtained in our lab suggests that visual acuity is reduced in CHL. Two specific aims will be addressed in this proposal: 1) we will characterize vestibular loss in CHL, and 2) we will evaluate the effect of vestibular loss on SVA and DVA in these children. We will focus on CHL who use a cochlear implant (CI), who have increased risk of vestibular loss due to implantation and etiology of hearing loss. This provides a population of CHL with vestibular loss where visual acuity can be better studied. In Aim 1, a new approach for assessing semicircular-canal function that has been developed for use in adults will be evaluated in children. Additionally, the relationship between severity of vestibular loss and gross motor performance will be investigated. In Aim 2, SVA and DVA will be assessed while sitting and under increasing demands of maintaining upright stance. This work will provide new knowledge regarding the prevalence of vestibular loss and the extent to which vestibular loss affects visual acuity in CHL. This will further advance our understanding of the natural compensation process of vestibular loss in CHL and lead to further investigations regarding the identification, implications, and habilitation of vestibular loss in CHL.