Unilateral Total Deafness in Children Clinical Problems with a Special View to Vestibular Function

Abstract

Routine examination of about 183,000 school pupils through 10 years revealed total deafness in one ear with normal hearing in the other ear in 1 in 1000. From among these subjects, the author made a thorough study of 122 selected at random.

The abnormality was found to be commoner in boys than in girls. It seldom involves an actual handicap, and frequently it is not recognized. The diagnosis of unilateral total deafness in this series as well as the shadow curve and bone conduction findings are discussed in some detail. X-rays revealed abnormal labyrinthine appearances in 18%, usually in the form of obliterated semicircular canals. In 2 cases the vestibule and the lateral semicircular canal made up one large cavity.

Vestibular function was absent on the deaf side in 28% and preserved in 72%, including one case with impaired and all the others with normal function. Two patients presented so-called “pseudocaloric nystagmus”; in one of these cases the labyrinthine loss was acquired, while in the other one it was congenital. A few cases of absent vestibular function were not compensated, despite the fact that they did not suffer from vertigo. Lacking compensation manifested itself as a certain preparedness for nystagmus directed to the good side and a considerably longer-lasting experimental nystagmus which could be elicited by rotation to the affected side as well as by hot calorization of the good side. Definite non-compensation was found in 5 cases with a history of meningitis.