this is a panel about hearing loss in childhood

Inner ear malformations present primarily with auditory symptoms while vestibular malformations, though clinically significant, are under-recognized .The seminar aims to explore the correlation between functional assessments—specifically audiological and vestibular evaluations—and radiological findings in patients with inner ear malformations. Particular attention is given to discrepancies that may arise between clinical and imaging data, and how these mismatches can influence therapeutic decisions. Incomplete cochlear partitions, 8th cranial nerve dysplasia and enlarged vestibular aqueduct are some examples. Third window syndromes blur the line between congenital and acquired pathology. It highlights the complex interplay between hearing and balance dysfunction in the context of inner ear anomalies.

Description: vestibular disorders in children are more common than previously thought. This session aims to educate the audience about the prevalence, symptoms, diagnosis, and treatment of vestibular dysfunction in the pediatric population

Outcome Objectives: . This session will offer practical tips and advice in how to recognize vestibular disorders in children, how to diagnose them, and how to treat them most effectively.

Background: over the past decade more attention has been given to children suffering from vestibular and balance problems. Recently, the IPBN (International Pediatric Balance Network) was founded to bring clinicians and scientists worldwide together to optimise care for these patients. The speakers for this session are board members of the IPBN: Leen Maes, professor in audiology at Ghent University (Belgium); Soumit Dasgupta, neurotologist and audiovestibular physician at Alder Hey Children’s Hospital (UK) and Josine Widdershoven, pediatric otorhinolaryngologist at Maastricht University Medical Center (the Netherlands).

A primary attribute for proper functioning in life is gaze stabilisation. This enables a subject to track objects, orient in space and perceive a three dimensional existence. The process is a complex interplay between peripheral sensors and the brain sending signals thereafter to oculomotor and spinal muscles. The vestibular system plays an important role in gaze stabilisation in response to gravity and to motion and connects with vast tracts in the brain that leads to final integration and perception.

Therefore, it is intuitive to understand that eye movements reflect this integration process and if there are deficits in the system, these movements become abnormal. There are sophisticated computerised gadgets available to measure the eye movements and their abnormalities. Since control of eye movements in the brain is highly site and topography specific, different abnormalities indicate the site of lesion in different areas of brain that are extremely sensitive and may predate imaging findings. To date more than 50 different eye movements are known, all of which tell a story and leads to a concrete diagnosis of neurological pathology.

This lecture discusses these eye movements with the author’s personal collection of more than 80 abnormal eye movements.

A primary attribute for proper functioning in life is gaze stabilisation. This enables a subject to track objects, orient in space and perceive a three dimensional existence. The process is a complex interplay between peripheral sensors and the brain sending signals thereafter to oculomotor and spinal muscles. The vestibular system plays an important role in gaze stabilisation in response to gravity and to motion and connects with vast tracts in the brain that leads to final integration and perception.

Therefore, it is intuitive to understand that eye movements reflect this integration process and if there are deficits in the system, these movements become abnormal. There are sophisticated computerised gadgets available to measure the eye movements and their abnormalities. Since control of eye movements in the brain is highly site and topography specific, different abnormalities indicate the site of lesion in different areas of brain that are extremely sensitive and may predate imaging findings. To date more than 50 different eye movements are known, all of which tell a story and leads to a concrete diagnosis of neurological pathology.

This lecture discusses these eye movements with the author’s personal collection of more than 80 abnormal eye movements.

Ototoxicity includes both cochleotoxicity and vestibulotoxicity. Whilst the former is well recognised, there is a distinct lack of awareness for the latter. Drug induced toxicity of the vestibular system generates significant morbidity and indeed is cryptogenic and remains undiagnosed. It is imperative that pharmacological agents that can damage the cochlea are recognised as agents that can also damage the vestibular system and hence evaluated from the vestibular point of view for prevention and treatment purposes. This lecture discusses in detail the different vestibulotoxic agents, their mechanism of action, their effect and the management of vestibulotoxicity. Alder Hey Hospitals affiliated to the University of Liverpool, UK has developed a vestibulotoxicity monitoring protocol for this purpose and one of the very few global centres to incorporate this as routine to monitor ototoxicity