Abstract
Motor development in infants is dependent upon the function of the inner ear balance organ (vestibular organ). Vestibular failure causes motor delays in early infancy and suboptimal motor skills later on. A vestibular test for newborns and infants that is applicable on a large scale, safe and cost effective is in demand in various contexts: in the differential diagnosis of early onset hearing loss to determine forms associated with vestibular failure; in early hearing habilitation with cochlear implant, indicating the vestibular predominant side; and in the habilitation of children affected by motor skill disorders, revealing the contribution of a vestibular failure. This work explored the feasibility of cervical vestibular evoked myogenic potentials (VEMP) in conjunction with newborn universal hearing screening program. VEMP was measured after the hearing tests and was evoked by bone-conducted stimuli. Moreover, stimulus delivery was regulated by neck muscle activity, with infants rested unconstrained in their parents´ arms and with the head supported by the operator´s hand. This VEMP protocol showed a high level of feasibility in terms of test viability and result reproducibility. VEMP integrated into the newborn hearing screening program may represent a practical method for large-scale assessment of balance function in infants.
Highlights
Diagnosis cCMV Connexin 26 mutation SOM VIII Nerve hypoplasia Not defined 26 (52) Down Syndrome Lebers Amaurosis Syndromic n.s
response rate (RR) was studied with respect to diagnosis, HL, completion rate (CR), prestimulus EMG cut-offs with non-parametric analysis
Correcting for all three determinants, the response rate increased from 73% to 91.5%
Summary
VEMP was defined as positive-negative EMG deflection with a latency of 12–17 ms for the first peak (p1) and 20–25 ms for the second peak (n1) after stimulus. 3. Muscle activity: the device could calculate the mean (SD) in μVolts of the prestimulus EMG samples collected in the trial. 6. Completion grade: measured as the number of collected responses (sweeps) for each trial. A cut-off of 120 sweeps defined test completion. Summary statistics were provided for both demographic and test variables These parameters were used as control variables for the analysis of two feasibility indicators, the completion rate (CR) and the response rate (RR). Non-parametric tests (χ2 test) were applied to study the association between CR and those determinants, whereas parametric tests (Mann-Whitney U-test) were applied to study the relation between CR and the number of collected sweeps, prestimulus EMG, and response amplitude. RR was studied with respect to diagnosis, HL, CR, prestimulus EMG cut-offs with non-parametric analysis.
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