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Vertigo/Dizziness in the Pediatric Group: A Retrospective Study

Year 2024, Volume: 46 Issue: 2, 190 - 198, 18.03.2024
https://doi.org/10.20515/otd.1404364

Abstract

This study aimed to retrospectively examine and analyze pediatric patients who presented to the Otolaryngology deparment with vertigo/dizziness and were referred to the Audiology department for vestibular evaluation. Between January 1, 2019 and May 30, 2023, 40 children, the majority of whom were girls (60%), were evaluated. The average age was 11.1±2.8 years (min: 5.8 max: 16.2 years). While the rate of direct application to the Otolaryngology was 55% (22/40), the rate of application to the Otolaryngology department after applying to other units was 45% (18/40). 39 of the pediatric patients (97.5%) were evaluated with at least one of the radiological imaging methods. While 15 children (38.4%) had abnormal findings, the results of 24 (61.5%) children were normal. Bilateral normal hearing was detected in 21 children (52.5%), and hearing loss was detected in 19 children (47.5%). There were more children with sensorineural type loss. Hearing loss ranged from mild to profound. The rate of performing at least one objective vestibular test was 38.4% (15/39), and the rate of performing at least 2 tests was 43.5% (17/39 children). There were no children who were tested together in all three tests. As age increased, the number of tests also increased similarly. Of the children for whom vestibular evaluation could be performed, 37.5% had objectively proven vestibular pathology. The number of children with both hearing loss and vestibular pathology was 10 (25%). Among all children presenting with vertigo, the most common etiological factors were inner ear anomaly (15%), migraine (12%), and cochlear implant surgery (10%). Vestibular evaluation in the pediatric group is a difficult and patience-requiring process. It is important to plan this evaluation process in a way that maximum information can be obtained in the shortest time and to include auditory evaluation.

References

  • 1. Halmagyi, G. M. Diagnosis and management of vertigo. Clin Med (Lond). (2005). 5(2):159-65.
  • 2. Grill, E., Strupp, M., Müller, M., & Jahn, K. Health services utilization of patients with vertigo in primary care: a retrospective cohort study. Journal of Neurology, (2014). 261, 1492-1498.
  • 3. Swain, S. K., Achary, S., & Das, S. R. Vertigo in pediatric age: Often challenge to clinicians. Int J Cur Res Rev, (2020). 12(18), 136-41.
  • 4. Neuhauser H. K., Radtke A., Von Brevern M., et al. Bur¬den of dizziness and vertigo in the community. Archives of Internal Medicine, (2008). 168:2118-124.
  • 5. Humphriss, R. L., Hall, A. J. Dizziness in 10 year old children: An epidemiological study. Int J Pediatr Otorhinolaryngol, (2011). 75(3):395-400.
  • 6. Li, C. M., Hoffman, H. J., Ward, B. K., Cohen, H. S., & Rine, R. M. Epidemiology of dizziness and balance problems in children in the United States: a population-based study. The Journal of Pediatrics, (2016). 171, 240-247.
  • 7. Erdoğan, E., Nur, B. G., & Dündar, N. O. Çocukluk Çağında Vertigo: Klinik ve Laboratuvar Bulgularının Değerlendirilmesi/Vertigo in Childhood: Evaluation of Clinical and Laboratory Findings. Türkiye Klinikleri. Tip Bilimleri Dergisi, (2012). 32(6), 1601.
  • 8. Çarman, K. B., & Yarar, C. Management of vertigo in children. Comprehensive Medicine, (2016). 8(1), 10-14.
  • 9. Batu, E. D., Anlar, B., Topçu, M., Turanlı, G., & Aysun, S. Vertigo in childhood: a retrospective series of 100 children. European Journal of Paediatric Neurology, (2015). 19(2), 226-232.
  • 10. Wiener-Vacher S. R. Vestibular disorders in children. International Journal of Audiology, (2008). 47:578-583.
  • 11. Rine, R. M., & Christy, J. B. Part I: Pediatric Vestibular Disorders. Vestibular impairments in children: Incidence, diagnoses, assessment and intervention, (2016). 1, 3.
  • 12. Clark, J. G. Uses and abuses of hearing loss classification. ASHA, (1981). 23, 493–500.
  • 13. Halmagyi, G. M., Curthoys, I. S. A clinical sign of canal paresis. Archives of Neurology. (1988). 45(7):737-739.
  • 14. Guan, Q., Zhang, L., Hong, W., et al. Video head impulse test for early diagnosis of vestibular neuritis among acute vertigo. Canadian Journal of Neurological Sciences. (2017). 44(5):556-561.
  • 15. MacDougall, H., Weber, K., McGarvie, L., et al. The video head impulse test: diagnostic accuracy in peripheral vestibulopathy. Neurology. (2009). 73(14):1134-1141.
  • 16. Hamilton, S. S., Zhou, G., & Brodsky, J. R. Video head impulse testing (VHIT) in the pediatric population. International Journal of Pediatric Otorhinolaryngology, (2015). 79(8), 1283-1287.
  • 17. Derinsu, U., Baş, E. İ., & Akdaş, F. Vesti̇büler uyarılmış mi̇yojeni̇k potansi̇yelleri̇n standardi̇zasyonu. Marmara Medical Journal, (2009). 22(2), 127-133.
  • 18. Fife, T. D., Colebatch, J. G., Kerber, K.A., et al. Practice guideline: Cervical and ocular vestibular evoked myogenic potential testing: Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology. Neurology. (2017). 89(22):2288-2296.
  • 19. Shepard, N., Jacobson, G. The caloric irrigation test. Handbook of clinical neurology. (2016). Vol. 137: Elsevier; p. 119-131.
  • 20. Park, B. R., Suh, J. S., Kim, M. S., et al. Effect of sensory deprivation or electrical stimulation on acute vestibular symptoms following unilateral labyrinthectomy in rabbit. Acta Oto-Laryngologica. (1995). 115(sup519):162-167.
  • 21. Jongkees, L., Maas, J., Philipszoon, A. Clinical nystagmography. Orl. 1962;24(2):65-93.
  • 22. Urbančič, N. B., Vozel, D., Kordiš, Š., Hribar, M., Urbančič, J., & Battelino, S. Indicators of pediatric peripheral vestibular disorder: A retrospective study in a tertiary referral center. International Journal of Pediatric Otorhinolaryngology, (2022). 159, 111221.
  • 23. Korkmaz, M. F., & Ekici, A. Retrospective review of children with vertigo: a 3-year experience. The European Research Journal, (2020). 6(5), 449-456.
  • 24. Erbek, S. H., Erbek, S. S., Yilmaz, I., Topal, O., Ozgirgin, N., Ozluoglu, L. N., & Alehan, F. Vertigo in childhood: a clinical experience. International Journal of Pediatric Otorhinolaryngology, (2006). 70(9), 1547-1554.
  • 25. Gruber, M., Cohen-Kerem, R., Kaminer, M., & Shupak, A. Vertigo in children and adolescents: Characteristics and outcome. The Scientific World Journal, (2012).
  • 26. Gedik-Soyuyüce, O., Gence-Gümüş, Z., Özdilek, A., Ada, M., & Korkut, N. Vestibular disorders in children: A retrospective analysis of vestibular function test findings. International Journal of Pediatric Otorhinolaryngology, (2021). 146, 110751.
  • 27. Ertuğrul G. Clinical use of child-friendly video head impulse test in dizzy children. Am J Otolaryngol. 2022;43(3):103432.
  • 28. Fina, M., Skinner, M., Goebel, J. A., Piccirillo, J. F., & Neely, J. G. Vestibular dysfunction after cochlear implantation. Otology & Neurotology, (2003). 24(2), 234-242.
  • 29. Vallim, M. G. B., Gabriel, G. P., Mezzalira, R., Stoler, G., & Chone, C. T. Does the video head impulse test replace caloric testing in the assessment of patients with chronic dizziness? A systematic review and meta-analysis. Brazilian Journal of Otorhinolaryngology, (2021). 87, 733-741.
  • 30. Vibert, D., Hausler, R., Kompis, M., Vischer, M. Vestibular function in patients with cochlear implantation. Acta Otolaryngol Suppl (2001). 545:29–34.
  • 31. Buchman, C. A., Joy, J., Hodges, A., Telischi, F. F., & Balkany, T. J. Vestibular effects of cochlear implantation. The Laryngoscope, (2004). 114(S103), 1-22.
  • 32. De Kegel, A., Maes, L., Baetens, T., Dhooge, I., & Van Waelvelde, H. The influence of a vestibular dysfunction on the motor development of hearing‐impaired children. The Laryngoscope, (2012). 122(12), 2837-2843.
  • 33. Choung, Y. H., Park, K., Moon, S. K., Kim, C. H., & Ryu, S. J. Various causes and clinical characteristics in vertigo in children with normal eardrums. International Journal of Pediatric Otorhinolaryngology, (2003). 67(8), 889-894.
  • 34. Niemensivu, R., Pyykkö, I., Valanne, L., & Kentala, E. Value of imaging studies in vertiginous children. International Journal of Pediatric Otorhinolaryngology, (2006). 70(9), 1639-1644.
  • 35. McCaslin, D. L., Jacobson, G. P., Lambert, W., English, L. N., & Kemph, A. J. The development of the vanderbilt pediatric dizziness handicap inventory for patient caregivers (DHI-PC). International Journal of Pediatric Otorhinolaryngology, (2015). 79(10):1662-1666.

Pediatrik Grupta Baş Dönmesi: Retrospektif Çalışma

Year 2024, Volume: 46 Issue: 2, 190 - 198, 18.03.2024
https://doi.org/10.20515/otd.1404364

Abstract

Bu çalışmada, Kulak Burun Boğaz (KBB) polikliniğine baş dönmesi ile başvurmuş ve vestibüler değerlendirme için Odyoloji bölümüne yönlendirilmiş çocuk hastalara ait verilerin retrospektif olarak incelenerek, analizlerinin yapılması amaçlanmıştır. 1 Ocak 2019 ile 30 Mayıs 2023 arasında çoğunluğu kız olan (%60) 40 çocuk değerlendirildi. Yaş ortalaması 11,1±2,8 yıldı (min:5,8 maks:16,2 yaş). KBB bölümüne direkt başvuru oranı % 55 (22/40) iken diğer birimlere başvuru sonrasında KBB’ye başvuru oranı % 45 (18/40) idi. Çocuk hastaların 39’u (% 97,5) radyolojik görüntüleme yöntemlerinden en az biri ile değerlendirilmiş olup 15 çocukta (%38,4) anormal bulgular mevcut iken 24 (%61,5) çocuğun sonuçları normaldi. 21 çocukta (% 52,5) bilateral normal işitme, 19 çocukta ise işitme kaybı saptandı (% 47,5). Sensörinöral tipte kaybı olan çocuklar daha fazlaydı. İşitme kaybı hafif dereceden çok ileri dereceye kadar değişmişti. En az bir objektif vestibüler test yapılabilme oranı % 38,4 (15/39), en az 2 test yapılma oranı ise % 43,5 (17/39 çocuk) idi. Üç testinde bir arada yapıldığı çocuk yoktu. Yaş arttıkça uyum sağlanan test sayısı da benzer şekilde artış göstermişti. Vestibüler değerlendirme yapılabilen çocukların % 37,5’inde objektif olarak kanıtlanmış vestibüler patoloji vardı. İşitme kaybı ve vestibüler patolojinin birlikte olduğu çocuk sayısı 10’du (%25). Vertigo ile başvuran tüm çocuklar arasında en yaygın etyolojik faktörler iç kulak anomalisi (%15) migren (%12) ve koklear implant ameliyatıydı (%10). Pediatrik grupta vestibüler değerlendirme zor ve sabır isteyen bir süreçtir. Bu değerlendirme sürecinin en kısa sürede, maksimum bilgi elde edilebilecek şekilde planlaması ve işitsel değerlendirmeye de yer verilmesi önemlidir.

Ethical Statement

Etik Kurul Onayı: Eskişehir Osmangazi Üniversitesi Klinik Araştırmalar Etik Kurulu Başkanlığı’ndan onay alınmıştır (Karar no: 22).

Supporting Institution

yok

Thanks

yok

References

  • 1. Halmagyi, G. M. Diagnosis and management of vertigo. Clin Med (Lond). (2005). 5(2):159-65.
  • 2. Grill, E., Strupp, M., Müller, M., & Jahn, K. Health services utilization of patients with vertigo in primary care: a retrospective cohort study. Journal of Neurology, (2014). 261, 1492-1498.
  • 3. Swain, S. K., Achary, S., & Das, S. R. Vertigo in pediatric age: Often challenge to clinicians. Int J Cur Res Rev, (2020). 12(18), 136-41.
  • 4. Neuhauser H. K., Radtke A., Von Brevern M., et al. Bur¬den of dizziness and vertigo in the community. Archives of Internal Medicine, (2008). 168:2118-124.
  • 5. Humphriss, R. L., Hall, A. J. Dizziness in 10 year old children: An epidemiological study. Int J Pediatr Otorhinolaryngol, (2011). 75(3):395-400.
  • 6. Li, C. M., Hoffman, H. J., Ward, B. K., Cohen, H. S., & Rine, R. M. Epidemiology of dizziness and balance problems in children in the United States: a population-based study. The Journal of Pediatrics, (2016). 171, 240-247.
  • 7. Erdoğan, E., Nur, B. G., & Dündar, N. O. Çocukluk Çağında Vertigo: Klinik ve Laboratuvar Bulgularının Değerlendirilmesi/Vertigo in Childhood: Evaluation of Clinical and Laboratory Findings. Türkiye Klinikleri. Tip Bilimleri Dergisi, (2012). 32(6), 1601.
  • 8. Çarman, K. B., & Yarar, C. Management of vertigo in children. Comprehensive Medicine, (2016). 8(1), 10-14.
  • 9. Batu, E. D., Anlar, B., Topçu, M., Turanlı, G., & Aysun, S. Vertigo in childhood: a retrospective series of 100 children. European Journal of Paediatric Neurology, (2015). 19(2), 226-232.
  • 10. Wiener-Vacher S. R. Vestibular disorders in children. International Journal of Audiology, (2008). 47:578-583.
  • 11. Rine, R. M., & Christy, J. B. Part I: Pediatric Vestibular Disorders. Vestibular impairments in children: Incidence, diagnoses, assessment and intervention, (2016). 1, 3.
  • 12. Clark, J. G. Uses and abuses of hearing loss classification. ASHA, (1981). 23, 493–500.
  • 13. Halmagyi, G. M., Curthoys, I. S. A clinical sign of canal paresis. Archives of Neurology. (1988). 45(7):737-739.
  • 14. Guan, Q., Zhang, L., Hong, W., et al. Video head impulse test for early diagnosis of vestibular neuritis among acute vertigo. Canadian Journal of Neurological Sciences. (2017). 44(5):556-561.
  • 15. MacDougall, H., Weber, K., McGarvie, L., et al. The video head impulse test: diagnostic accuracy in peripheral vestibulopathy. Neurology. (2009). 73(14):1134-1141.
  • 16. Hamilton, S. S., Zhou, G., & Brodsky, J. R. Video head impulse testing (VHIT) in the pediatric population. International Journal of Pediatric Otorhinolaryngology, (2015). 79(8), 1283-1287.
  • 17. Derinsu, U., Baş, E. İ., & Akdaş, F. Vesti̇büler uyarılmış mi̇yojeni̇k potansi̇yelleri̇n standardi̇zasyonu. Marmara Medical Journal, (2009). 22(2), 127-133.
  • 18. Fife, T. D., Colebatch, J. G., Kerber, K.A., et al. Practice guideline: Cervical and ocular vestibular evoked myogenic potential testing: Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology. Neurology. (2017). 89(22):2288-2296.
  • 19. Shepard, N., Jacobson, G. The caloric irrigation test. Handbook of clinical neurology. (2016). Vol. 137: Elsevier; p. 119-131.
  • 20. Park, B. R., Suh, J. S., Kim, M. S., et al. Effect of sensory deprivation or electrical stimulation on acute vestibular symptoms following unilateral labyrinthectomy in rabbit. Acta Oto-Laryngologica. (1995). 115(sup519):162-167.
  • 21. Jongkees, L., Maas, J., Philipszoon, A. Clinical nystagmography. Orl. 1962;24(2):65-93.
  • 22. Urbančič, N. B., Vozel, D., Kordiš, Š., Hribar, M., Urbančič, J., & Battelino, S. Indicators of pediatric peripheral vestibular disorder: A retrospective study in a tertiary referral center. International Journal of Pediatric Otorhinolaryngology, (2022). 159, 111221.
  • 23. Korkmaz, M. F., & Ekici, A. Retrospective review of children with vertigo: a 3-year experience. The European Research Journal, (2020). 6(5), 449-456.
  • 24. Erbek, S. H., Erbek, S. S., Yilmaz, I., Topal, O., Ozgirgin, N., Ozluoglu, L. N., & Alehan, F. Vertigo in childhood: a clinical experience. International Journal of Pediatric Otorhinolaryngology, (2006). 70(9), 1547-1554.
  • 25. Gruber, M., Cohen-Kerem, R., Kaminer, M., & Shupak, A. Vertigo in children and adolescents: Characteristics and outcome. The Scientific World Journal, (2012).
  • 26. Gedik-Soyuyüce, O., Gence-Gümüş, Z., Özdilek, A., Ada, M., & Korkut, N. Vestibular disorders in children: A retrospective analysis of vestibular function test findings. International Journal of Pediatric Otorhinolaryngology, (2021). 146, 110751.
  • 27. Ertuğrul G. Clinical use of child-friendly video head impulse test in dizzy children. Am J Otolaryngol. 2022;43(3):103432.
  • 28. Fina, M., Skinner, M., Goebel, J. A., Piccirillo, J. F., & Neely, J. G. Vestibular dysfunction after cochlear implantation. Otology & Neurotology, (2003). 24(2), 234-242.
  • 29. Vallim, M. G. B., Gabriel, G. P., Mezzalira, R., Stoler, G., & Chone, C. T. Does the video head impulse test replace caloric testing in the assessment of patients with chronic dizziness? A systematic review and meta-analysis. Brazilian Journal of Otorhinolaryngology, (2021). 87, 733-741.
  • 30. Vibert, D., Hausler, R., Kompis, M., Vischer, M. Vestibular function in patients with cochlear implantation. Acta Otolaryngol Suppl (2001). 545:29–34.
  • 31. Buchman, C. A., Joy, J., Hodges, A., Telischi, F. F., & Balkany, T. J. Vestibular effects of cochlear implantation. The Laryngoscope, (2004). 114(S103), 1-22.
  • 32. De Kegel, A., Maes, L., Baetens, T., Dhooge, I., & Van Waelvelde, H. The influence of a vestibular dysfunction on the motor development of hearing‐impaired children. The Laryngoscope, (2012). 122(12), 2837-2843.
  • 33. Choung, Y. H., Park, K., Moon, S. K., Kim, C. H., & Ryu, S. J. Various causes and clinical characteristics in vertigo in children with normal eardrums. International Journal of Pediatric Otorhinolaryngology, (2003). 67(8), 889-894.
  • 34. Niemensivu, R., Pyykkö, I., Valanne, L., & Kentala, E. Value of imaging studies in vertiginous children. International Journal of Pediatric Otorhinolaryngology, (2006). 70(9), 1639-1644.
  • 35. McCaslin, D. L., Jacobson, G. P., Lambert, W., English, L. N., & Kemph, A. J. The development of the vanderbilt pediatric dizziness handicap inventory for patient caregivers (DHI-PC). International Journal of Pediatric Otorhinolaryngology, (2015). 79(10):1662-1666.
There are 35 citations in total.

Details

Primary Language Turkish
Subjects Otorhinolaryngology, Audiology
Journal Section ORİJİNAL MAKALE
Authors

Arzu Kırbaç 0000-0003-3215-156X

Ercan Kaya 0000-0002-9961-0313

Handan Turan Dizdar 0000-0002-2986-7463

Armağan İncesu 0000-0001-8467-5950

Publication Date March 18, 2024
Submission Date December 14, 2023
Acceptance Date January 16, 2024
Published in Issue Year 2024 Volume: 46 Issue: 2

Cite

Vancouver Kırbaç A, Kaya E, Turan Dizdar H, İncesu A. Pediatrik Grupta Baş Dönmesi: Retrospektif Çalışma. Osmangazi Tıp Dergisi. 2024;46(2):190-8.


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