先天性盲聾児の平衡と運動の発達

抄録

Background: The relationship of visual vestibular interaction with congenitally visual and hearing impairment in children has been discussed. The cochlear and vestibular organs are closely related anatomically and phylogenetically. Many studies have revealed the abnormal vestibular function and delayed motor development in the cases of severely hearing impaired children. Bilateral vestibular dysfunction may be manifested as the loss of postural control and the delay of development in gross motor function. In addition, congenitally blind children manifest delayed motor development due to the difficulties in space perception. Methods: The vestibular functions and gross motor development were assessed in 4 congenitally deafblind children. Of the 4 cases, one patient had congenital rubella syndrome and one had CHARGE syndrome. In all patients there was severe hearing loss with severe visual impairment. Results: Motor development in all cases was significantly delayed. None of the patients could stand up and walk by themselves until they were at least 2 years and 4 months old. The results of the rotational chair test in two patients showed no response. Conclusions: Because of loss of visual vestibular interaction, the gross motor development in all severe congenital deafblind cases was found to be delayed further than that in the cases with only congenital hearing impairment. Careful treatment and planning for rehabilitation or placement of a cochlear implant in deafblind children is needed to improve their quality of life.