Balance disorders in hearing impaired children: prevalence, current possibilities of diagnostics and rehabilitation (scoping review)

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Abstract
The review is devoted to the problem of balance disorders combined with hearing loss in pediatric population. The balance function is implemented by three systems: visual, somatosensory and vestibular and plays an important role in the child’s development. The critical period for vestibular system development occurs prior to a child taking their first independent steps and the balance system continues to mature until approximately 4-6 years of age. According to various sources, vestibular disorders may occur in children with sensorineural hearing loss with a frequency ranging from 8% to 85% without any correlation to the degree of hearing impairment. These balance disorders, in combination with hearing loss, have been shown to limit various aspects of a child’s development such as motor and cognitive skill acquisition, learning, sports participation, physical activity, written expression, reading ability, communication, and social interaction. In modern clinical practice, a framework for an algorithm has been developed to diagnose balance disorders in children of different ages. These methods should be tailored to each child’s developmental level and be highly informative, while also complementing each other in terms of results. Approaches are currently being explored to screen for vestibular issues in children with confirmed hearing loss. Data on changes in balance in children underwent cochlear implantation is conflicting. In the immediate postoperative period, some patients may experience transient vestibular dysfunction, but over time, there is a general trend towards improved balance. Discussions are underway regarding the potential of vestibular rehabilitation as part of a comprehensive approach for children with hearing impairment. This includes enhancing neuroplasticity through adaptation, habituation, and substitution. It is essential to investigate the efficacy of various methods of rehabilitation for children with hearing loss who experience balance issues.

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