A Systematic Review on the Association Between Vestibular Dysfunction and Balance Performance in Children With Hearing Loss.

Most studies were small and recruited children who happened to be available in clinic, so the children studied may have had more severe vestibular or balance symptoms than children with hearing loss in general. No study blinded the researchers who assessed balance, and clinical balance tests are subjective, so expectations may have shaped how results were scored. Only one study reported enough detail to show whether it had enough children to detect a difference. Studies used different vestibular tests, different balance tests and different cut-offs for calling a result abnormal, so their results cannot be compared directly. Control groups were matched for age, or age and gender, but not for other things that affect balance such as other medical conditions or medication use. The review included only studies published in English, and the authors note that studies reporting a link may be more likely to have been published than studies finding none.

Do not read this review as evidence that vestibular rehabilitation improves balance in children with hearing loss. None of the 20 studies tested a treatment, most were small and unblinded, and the authors did not pool the results because the studies were too poor in quality to combine. Do not assume every child with hearing loss has a balance problem either. One of the two studies that found no link included 33 children with unilateral vestibular dysfunction, all of whom tested normal on balance.