Hanifi KORKMAZ, Sevilay HANÇER TECİMER
Praxis of Otorhinolaryngology - 2026;14(2):122-133
Objectives: This study examined whether sensorineural hearing loss (SNHL) severity affects the sensory components of postural control in asymptomatic young to middle-aged adults under increasing multisensory load using a virtual reality (VR)-based Clinical Test of Sensory Interaction on Balance (CTSIB). Patients and Methods: Between October 2025 and February 2026, a prospective cross-sectional study was performed on 53 participants (23 males, 30 females; mean age: 26.51+/-4.27 years; range: 18 to 57 years). Participants were categorized into three groups according to their hearing status: the healthy control group (n = 24), the mild SNHL group (n = 21), and the moderate SNHL group (n = 8). Postural control was assessed under four conditions: C1 (silent-standard vision), C2 (music-standard vision), C3 (silent-optokinetic vision), and C4 (music-optokinetic vision). Composite balance scores and VR-CTSIB sensory subcomponents were analyzed using condition-wise nonparametric tests. Subjective workload was evaluated using the mental demand and effort subscales of the National Aeronautics and Space Administration Task Load Index. Results: Composite balance performance differed between groups in a condition-dependent manner, with greater separation under higher multisensory load. Somatosensory and visual components showed increasing group differences, whereas vestibular-based strategies diverged only under multisensory conflict. Visual preference differed only in the music-standard vision condition, indicating a context-dependent shift in sensory weighting. Subjective workload increased with sensory conflict, while between-group differences diminished under the highest load. Conclusion: In asymptomatic adults, hearing loss is associated with condition-specific postural control vulnerability that emerges under auditory-visual sensory conflict, supporting impaired sensory reweighting rather than a global balance deficit. Virtual reality-based CTSIB protocols provide a sensitive framework for detecting these effects.
