Starting up a vestibular test battery in infants and children: the Amsterdam experience
P. Brienesse, F. Ebbens
Objectives
To report on our experiences with a vestibular test battery in infants and young children.
Methods
Retrospective analysis of the clinical vestibular data collected from all children that enrolled the test battery from the start in October 2021. The vestibular test battery consists of an initial check for spontaneous and gaze-evoked nystagmus, a smooth pursuit eye tracking test and a saccades test. It is followed by an optokinetic nystagmus test (OKN), a video head impulse test (vHIT), a cervical vestibular myogenic potential measurement (cVEMP), and a velocity-step test in a rotary chair. A qualitative analysis of the data leads to the diagnoses of a uni- or bilateral vestibular impairment.
Primary outcome is the success rate of the different vestibular tests. Secondary outcomes are the qualitative vestibular diagnosis of all children, and the pre- and post-implantation data from the subset of children receiving cochlear implants.
Results
Vestibular data were collected in 53 children (age range 7 months - 10 years, median 24 months). The initial check for nystagmus, the smooth pursuit and saccades tests could successfully be performed in all children. One child could not perform the OKN test (2%). Off all tests, the vHIT proved to be the most challenging, since it could not be performed in 8% of the children, with an additional 13% of children with a successful vHIT at only one side. The cVEMP was unsuccessful in 8% of the children, and unilateral successful in 2% of the children. The velocity-step test was unsuccessful in 2% of the children, with a unilateral success in 4%.
Combining all test results, in 4% of the children no conclusions on the vestibular function could be drawn. 70% of the children showed no signs of vestibular dysfunction, 11% showed a unilateral vestibular impairment, and 15% a bilateral impairment. In the 15 ears of 8 children that were tested pre- and post-implantation, no vestibular impairment could be contributed to the process of cochlear implantation.
Conclusion
Vestibular testing is relevant, feasible and relatively easy to perform in children from the age of 7 months.

Starting up vestibular diagnostics in infants and children: the Amsterdam experience.

It is with great pleasure and enthusiasm, that on behalf of the Cochlear Implant centers of the Radboud UMC in Nijmegen and Erasmus MC Sophia Children’s Hospital in Rotterdam to invite you to attend the 16th European Symposium on Pediatric Cochlear Implantation to Rotterdam, the Netherlands in 2023.

Yours sincerely, on behalf of the CI Centers at Radboud UMC and Erasmus MC,