Affiliations: [a] Department of Otolaryngology, Head & Neck Surgery, Universidade Federal de São Paulo/Escola Paulista de Medicina (UNIFESP/EPM) (São Paulo, SP, Brazil) | [b] Department of Otolaryngology Head & Neck Surgery, University of Minnesota (Minnesota, MN, USA) | [c] Paparella Ear Head & Neck Institute (Minnesota, MN, USA)
Correspondence:
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Corresponding author: Rafael da Costa Monsanto, M.D., Ph.D student, Universidade Federal de São Paulo / Escola Paulista de Medicina (UNIFESP / EPM). R dos Otonis, 700, piso superiro - Vila Clementino, São Paulo, Brazil; CEP: 04025-002; E-mail: rafaelmonsanto@hotmail.com.
Abstract: BACKGROUND:Evidence to support potential links between chronic otitis media (COM) and vestibular impairment/postural balance control issues is lacking. OBJECTIVE:To investigate whether COM associates with vestibular symptoms, balance problems, and abnormalities in vestibular function tests. METHODS:We selected 126 patients with COM and excluded patients with any identifiable underlying causes for vestibular dysfunction. Fifty-two healthy volunteers were included as controls. All subjects underwent anamnesis, physical examination, posturography, and video-head impulse tests. RESULTS:We found a high prevalence of vestibular symptoms (58.4%) among patients with COM, while only 2% of the controls had vestibular symptoms. There was a positive correlation between COM activity with the presence of tinnitus and vestibular symptoms (P < 0.05). Clinical vestibular tests were abnormal in 63% of patients with COM, and those positively associated with presence of vestibular symptoms. Posturography results shown worse postural balance control in patients with COM as compared with controls, especially in the limit of stability (LOS) (Mean LOS, COM = 157.56 cm2; controls = 228.98 cm2; p < 0.001) and worse results in the test with eyes closed while standing on a foam mattress (sway area, COM = 10.91 cm2; controls = 5.90 cm2; p < 0.001) in patients with COM as compared with controls. We did not observe differences in the average vestibuloocular reflex gains in the video-head impulse test between our COM and control groups. CONCLUSIONS:Our results show that COM associates with higher prevalence of vestibular symptoms and abnormalities in clinical vestibular function tests, and worse postural control as compared with controls. Among patients with COM, the activity of the middle-ear inflammation seemed to positively associate with the severity of hearing and balance problems.
Keywords: Otitis media, vestibular function tests, vertigo, dizziness, postural
balance
