الفهرس 
Vestibular Evaluation in ChildrenOnly 14 pages are availabe for public view
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Abstract
Severely delayed posturomotor milestones such as stabilizing the head, sitting and walking independently result from complete absence of vestibular information, whether congenital or acquired at very young age (Jacot et al., 2009).. Vestibular end-organs and the cochlea share a common embryological origin and developments thereafter a direct anatomical relationship in the inner ear (Ibrahim et al., 2017). . Cochlear implantation surgery frequently affects the vestibular apparatus, which is in close anatomical proximity to the auditory system. Different mechanisms could lead to vestibular dysfunction during or after CI surgery such as: direct trauma caused by electrode insertion, acute serous labyrinthitis due to cochleostomy, foreign body reaction with labyrinthitis, endolymphatic hydrops and electrical stimulation from the implant itself. The aim of this work was evaluation of Vestibulo-Ocular reflex (VOR) in children with cochlear implant using Rotatory chair testing. Our study included sixty children divided into three groups: 20 normal hearing children group (G1) as control group, 20 children with severe or severe to profound hearing loss group (G2) and 20 cochlear implanted children group (G3) as study group. All children were subjected to full audiological history, basic audiological evaluation, bedside tests, dizziness handicap inventory (DHI) for children and vestibulo-ocular reflex testing using SHA and VST of Rotatory chair. Our results revealed that there were five children in each study groups had delayed motor development in form of delayed head support at 6 months, sitting at 9 months, crawling at 12 months and walking at 2 years. There was a statistical significant difference between control and study groups in Arabic DHI questionnaire for children. Bed-side test results showed statistical significant differences in Sharpened Romberg test and Fukuda stepping test among the three groups. While no abnormalities were found in other tests. SHA and VST of Rotatory chair were done for all groups. In severe or severe to profound hearing loss group, there were 13 children (65%) had abnormal SHA test results: 10 children (50%) had unilateral peripheral vestibular affection and 3 children (15%) had bilateral vestibular affection. While in cochlear implant group there were 11 children (55%) had abnormal Rotatory chair test results: 8 children (40%) had unilateral peripheral vestibular hypofunction and 3 children (15%) had bilateral vestibular hypofunction. Comparison of duration of HA and CI use results revealed statistically significant difference. Moreover, correlations were done between Rotatory chair tests (SHA and VST) , age, duration of HA, CI using and DHI in study groups. Results revealed that there was no significant correlation between SHA test, age, duration of HA using and DHI in G2, but there was positive significant correlation between gain step velocity CCW and age. In G3, there was a significant negative correlation between DHI and gain at frequencies 0.04 Hz, 0.16 Hz and 0.64 Hz and between duration of CI and gain at frequencies 0.16 Hz ad 0.32 Hz. Also, there was a significant positive correlation between age and asymmetry at frequency 0.64 Hz and between duration of CI and asymmetry at frequency 0.64 Hz. Also, there was a significant positive correlation between DHI and phase at frequencies 0.04 Hz, 0.08 Hz, between duration of CI and phase at frequency 0.64 Hz and between age and phase at frequency 0.64 Hz. But, there was no significant correlation between velocity step test, age, duration of CI using and Arabic DHI.