The vestibule is the balance half of the
inner ear. The other half is the cochlea which controls hearing.
For a tour of the inner ear click here. http://www.cochlea.org
The vestibule is composed of 3 semicircular canals.
- One is in the vertical position and gives information about
movement of the head up and down.
- One is horizontal for movement side to side.
- One is tilted outward in each side to give the sense of head
movement between the horizontal and vertical.
When the vestibule does not work at birth (as is the case
in Usher Syndrome Type I, in many cases of CHARGE, and in
a third of all children in schools for the deaf), the children
have major problems with gross motor development. So-called
vestibular dysfunction causes them to have unusual ways of
getting around before walking such as:
- combat crawling or
- lying on on the back and pushing backward with their feet
- or the "5-point crawl" which is very typical and
means that they put their head down on the ground as they
crawl. The "5-point" crawl results in a worn-off
spot of hair in the front or on the side.
If the only problem
is vestibular dysfunction, the average age of walking is about
24 months. If other problems are present such as vision
loss or muscle weakness, walking may not occur until 3-4 years
(typical of CHARGE Syndrome).
Children lacking this inner ear balance also take longer to
trust their muscles and joints. They have problems with
activities like riding a bicycle where they do not get feedback
from their legs. Some eventually can become athletes
but usually prefer individual sports such as track or swimming
because of their vision loss. It is life saving to keep
them out of murky water because their vestibules will not
tell them which way is up.
Sandra L.H. Davenport, M.D..
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