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The growing evidence of the need for pediatric vestibular evaluation, as well as the availability of successful treatment options for children, is attracting the attention ofmany professionals and sparking much interest in the development of pediatric balance centers in North America. Complete balance function assessment and rehabilitation in children requires specialized knowledge and practices of professionals in multiple disciplines. While individual specialists provide useful test information and recommendations for patients, the collaboration of specialists working in a multidisciplinary fashion allows the information to become more powerful, providing the patients and their families with a comprehensive plan. Currently, there are only a handful of pediatric balance centers in North America and most of the centers have been in existence less than 10 years. Thus, this new initiative is in its infancy. Educating oneself, administrators, referral sources, and interdisciplinary colleagues is crucial for gathering support for the enormous endeavor of developing such a center. There are many resources one can draw from, including the works found in this issue. Our hope is that this special Seminars in Hearing may serve as a companion guide to anyone interested in performing pediatric vestibular evaluations and/or developing a multidisciplinary pediatric balance center. [ABSTRACT FROM AUTHOR]

Objectives/hypothesis: To establish the prevalence of abnormal vestibular test findings in children with enlarged vestibular aqueduct (EVA) and determine if these findings correlate with clinical symptoms, radiographic findings (EVA size and laterality), audiometric findings, and genetic testing in these patients.Study Design: Prospective cohort.Methods: Patients 3 to 12 years of age with hearing loss and imaging findings consistent with EVA treated at our tertiary care institution were sequentially enrolled from 2009 to 2011. The following six outcome measurements were analyzed: audiometric findings, EVA laterality, temporal bone measurements, genetic testing, vestibular testing (cervical-evoked myogenic potentials, posturography, rotational chair, and calorics), and vestibular symptoms.Results: Twenty-seven patients with EVA (mean age 9.2 years, 48% female) were enrolled in and completed the study. Vertigo was reported in six patients. Twenty-four of 27 (89%) had at least one abnormal vestibular test result. Midpoint and operculum size correlated with directional preponderance (P = .042 and P = .032, respectively). Also, high-frequency pure tone average (HFPTA) correlated with unilateral weakness (P = .002). Walking at a later age correlated with abnormal posturography results. There was no correlation between EVA laterality and vestibular test findings.Conclusion: We found a high rate of vestibular pathology in children with EVA; however, the prevalence of abnormal vestibular test findings in this patient population was not correlated with vestibular symptoms. Enlarged vestibular aqueduct size, HFPTA, and walking at a later age were correlated with abnormal vestibular test findings. In view of these results, it may be prudent to consider vestibular testing in children with these clinical characteristics.Level Of Evidence: 2b. Laryngoscope, 126:2344-2350, 2016. [ABSTRACT FROM AUTHOR]