Department and Clinic of Otolaryngology, Head and Neck Surgery, Wroclaw Medical University, Poland.
Adv Clin Exp Med. 2020 Mar;29(3):325-330. doi: 10.17219/acem/112601.
Otitis media with effusion (OME) is the most common cause of hearing impairment among children in developed nations. Middle ear (ME) fluid accumulation leads to progressive hearing impairment, usually of the conductive type. In some cases, mixed hearing loss associated with OME has been noted. It was reported that effusion in the ME has a negative impact on the vestibular system of the inner ear.
The aim of this random-sample cohort study was to evaluate postural stability and the influence of ME drainage on vestibulospinal reflexes in children with OME, and to determine whether disturbances in the vestibular organ correlate with a sensorineural component in OME-related hearing loss.
The study group consisted of 53 children with bilateral OME who were treated with bilateral ME drainage. The study group was divided into subgroups according to hearing loss. The control group consisted of 29 healthy children. Vestibular function and hearing evaluation were performed before and 4 weeks after drainage.
A comparison of the stabilograms of the study group and the control group revealed elevated parameters in most of the tests. In the subgroup with mixed hearing loss, either before or after ME drainage, elevated stabilogram parameters were found in all tests. Posturography revealed vestibular system disturbances before and after ME drainage in the subgroup with mixed hearing loss, especially before ME drainage. The stabilogram parameters in the subgroup with conductive hearing loss after ME drainage were better in most tests in comparison to those before the procedure.
The presence of effusion in the ME has a negative effect on the inner ear. We highlight the importance of monitoring the condition of the vestibular system in all children with OME, especially in cases with mixed hearing loss and more advanced clinical stages of the disease.
分泌性中耳炎（OME）是发达国家儿童听力障碍的最常见原因。中耳（ME）液体积聚导致进行性听力损失，通常为传导性听力损失。在某些情况下，OME 相关的混合性听力损失也有报道。据报道，ME 中的积液对内耳的前庭系统有负面影响。
本随机抽样队列研究旨在评估OME 患儿的姿势稳定性以及 ME 引流对前庭脊髓反射的影响，并确定前庭器官的紊乱是否与 OME 相关听力损失的感音神经性成分相关。
研究组由 53 例双侧 OME 患儿组成，这些患儿接受了双侧 ME 引流治疗。研究组根据听力损失情况进一步分为亚组。对照组由 29 例健康儿童组成。在引流前后分别进行前庭功能和听力评估。
与对照组相比，研究组的平衡测试图显示大多数测试的参数升高。在混合性听力损失亚组中，无论是在 ME 引流之前还是之后，所有测试均发现平衡测试图参数升高。在混合性听力损失亚组中，ME 引流前后的动态平衡图均显示前庭系统紊乱，尤其是在 ME 引流之前。与治疗前相比，ME 引流后传导性听力损失亚组的大多数测试的平衡测试图参数均有所改善。
ME 中的积液对内耳有负面影响。我们强调了在所有 OME 患儿中监测前庭系统状况的重要性，尤其是在混合性听力损失和疾病更晚期的情况下。
