Pazdro-Zastawny Katarzyna, Pośpiech Lucyna, Zatoński Tomasz
Department and Clinic of Otolaryngology, Head and Neck Surgery, Wroclaw Medical University, Poland.
Medicus Clinic, Poland.
Int J Pediatr Otorhinolaryngol. 2018 Jun;109:13-16. doi: 10.1016/j.ijporl.2018.03.015. Epub 2018 Mar 19.
Otitis media with effusion (OME) is one of the most common clinical conditions in childhood. Fluid accumulation in the middle ear may impact inner ear.
The purpose of this random sample cohort study was to investigate whether the past history of middle ear effusion has a long-term negative impact on the vestibular system in children.
The study was carried out on 22 children aged 7-15 years who had undergone drainage of the middle ear 5 years before evaluation. The control group consisted of 29 healthy children aged 4-17 years. Vestibular function was examined using sway posturography and electronystagmography (ENG).
The stabilogram parameters of the study group and the control group were compared. The field of developed area (FDA) and the average body sway velocity (ASV) were analyzed. Elevated stabilogram parameters of FDA and ASV, both with eyes open and eyes closed, were found in the study group. Statistically significant values (p < 0.05) were present for ASV with eyes open and with eyes closed. The ENG recordings were analyzed in both groups. In the study group, spontaneous nystagmus was observed in 40.9% of the children and positional nystagmus occurred in 63.6% of the children. According to tests, eye tracking test was impaired in 27.3% of cases. Rotatory chair testing revealed asymmetry in 18.2% of the children.
The presence of effusion in the middle ear in the past has a negative impact on the vestibular part of the inner ear. Clinicians should be aware of the possible negative impact of middle ear effusion on the vestibular function in children with a history of otitis media with effusion. With seeimingly asymptomatic children clinicians should inquire parents about symptoms of dysequlibrium and imbalance.
中耳积液（OME）是儿童期最常见的临床病症之一。中耳内的液体蓄积可能会影响内耳。
本随机样本队列研究的目的是调查中耳积液的既往史是否会对儿童的前庭系统产生长期负面影响。
对22名7至15岁的儿童进行了研究，这些儿童在评估前5年曾接受过中耳引流。对照组由29名4至17岁的健康儿童组成。使用姿势摆动描记法和眼震电图（ENG）检查前庭功能。
比较了研究组和对照组的稳定图参数。分析了发育区域面积（FDA）和平均身体摆动速度（ASV）。研究组在睁眼和闭眼时均发现FDA和ASV的稳定图参数升高。睁眼和闭眼时ASV的差异具有统计学意义（p<0.05）。对两组的ENG记录进行了分析。在研究组中，40.9%的儿童观察到自发性眼震，63.6%的儿童出现位置性眼震。根据测试，27.3%的病例眼跟踪测试受损。转椅测试显示18.2%的儿童存在不对称性。
过去中耳积液的存在对内耳的前庭部分有负面影响。临床医生应意识到中耳积液对有中耳积液性中耳炎病史儿童前庭功能可能产生的负面影响。对于看似无症状的儿童，临床医生应询问家长有关平衡失调和失衡的症状。
