a Department of Otorhinolaryngology, Head and Neck Surgery , Universidade Federal de São Paulo/Escola Paulista de Medicina (UNIFESP/EPM) , São Paulo , Brazil.
b Department of Otolaryngology , University of Minnesota , Minneapolis , MN , USA.
Ann Med. 2018 Aug;50(5):391-401. doi: 10.1080/07853890.2018.1470665. Epub 2018 May 6.
The association between otitis media and vestibular symptoms has been hypothesized in the past. Thus, in this study, we aimed to critically analyze (based in a systematic review of the literature) whether patients who have otitis media are at greater risk of developing vestibular impairment or not.
We performed a systematic review of the literature and identified potentially relevant articles reporting vestibular symptoms and results of vestibular function tests in patients with otitis media through searches of the PubMED, Web of Science, Scopus, and Google Scholar databases. The quality of the final set of records was assessed using the "Newcaste-Ottawa Scale".
Of the 2334 records searched, 43 met our inclusion and exclusion criteria, and those included 2250 patients. The records comprised 20 longitudinal studies, 21 cross-sectional studies, and 2 case reports. Regarding the type of otitis media studied, 25 examined vestibular impairment in otitis media with effusion, 6 acute otitis media, and 12 chronic otitis media. Results of anamnesis, clinical exams, and several vestibular function tests are reported and critically discussed.
Most studies evaluating the association between otitis media and vestibular symptoms have potential methodological flaws. Clinical evidence suggests that patients with otitis media have increased chances for having vestibular symptoms, delayed acquisition of developmental milestones, and abnormalities in several vestibular function tests as compared with controls. Future studies with rigorous methodology aiming to assess the clinical significance (and prognostic factors) of the association between otitis media and vestibular impairment are warranted. Key message Several studies demonstrated long-term sequelae secondary to otitis media. However, the evidence supporting those assumptions are based in low-quality evidence. Thus, better structured studies are warranted to better understand the clinical relevance of such association.
过去曾假设中耳炎与前庭症状之间存在关联。因此，在这项研究中，我们旨在通过对文献进行系统评价（基于系统评价）来批判性地分析患有中耳炎的患者是否更容易发生前庭功能障碍。
我们对文献进行了系统评价，并通过搜索 Pubmed、Web of Science、Scopus 和 Google Scholar 数据库，确定了报道中耳炎患者前庭症状和前庭功能检查结果的潜在相关文章。使用“纽卡斯尔-渥太华量表”评估最终记录集的质量。
在搜索到的 2334 条记录中，有 43 条符合我们的纳入和排除标准，其中包括 2250 名患者。这些记录包括 20 项纵向研究、21 项横断面研究和 2 项病例报告。关于研究的中耳炎类型，25 项研究评估了分泌性中耳炎中的前庭功能障碍，6 项研究评估了急性中耳炎，12 项研究评估了慢性中耳炎。报告并批判性地讨论了病史、临床检查和几项前庭功能检查的结果。
大多数评估中耳炎与前庭症状之间关联的研究都存在潜在的方法学缺陷。临床证据表明，与对照组相比，中耳炎患者发生前庭症状、发育里程碑延迟以及几项前庭功能检查异常的可能性增加。需要进行具有严格方法学的未来研究，以评估中耳炎与前庭功能障碍之间关联的临床意义（和预后因素）。
几项研究表明中耳炎存在长期后遗症。然而，支持这些假设的证据基于低质量证据。因此，需要进行结构更好的研究，以更好地了解这种关联的临床意义。
