Universidade Federal de São Paulo, Escola Paulista de Medicina (Unifesp/EPM), Departamento de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, São Paulo, SP, Brazil.
Universidade Federal de São Paulo, Escola Paulista de Medicina (Unifesp/EPM), Departamento de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, São Paulo, SP, Brazil.
Braz J Otorhinolaryngol. 2022 Sep-Oct;88(5):675-682. doi: 10.1016/j.bjorl.2020.09.006. Epub 2020 Oct 16.
In recent years, scientific evidence has shown that chronic otitis media may cause balance and vestibular dysfunction.
To compare the results of the video head impulse test (gain and symmetry of the vestibulo-ocular reflex and presence of covert and overt saccades) in patients with chronic otitis media and controls.
Cross-sectional study of patients with chronic otitis media (study group), aged between 18 and 60 years. The patients in the study group were further divided according to the chronic otitis media type as (1) non-suppurative, (2) suppurative, and (3) cholesteatomatous. For the comparative analysis, we selected volunteers with no history of ear and vestibular diseases (control group), who met the same inclusion and exclusion criteria as the study group. Patients in both groups underwent a video head impulse test.
The study group consisted of 96 volunteers, and the control group of 61 individuals. The prevalence of vestibular symptoms was 66% in the study group and 3.2% in the control group (p < 0.001). The results show a higher prevalence of changes in the vestibulo-ocular reflex gain (22.9%) and corrective saccades (12.6%) in the chronic otitis media group compared to the control group (p < 0.001). Despite the higher prevalence of changes in gain, the average vestibulo-ocular reflex gains in the chronic otitis media groups were within the pre-defined values of normality; however, the mean vestibulo-ocular reflex gain in the anterior semicircular canal was statistically worse in the cholesteatomatous chronic otitis media group compared to controls (p < 0.001). Regarding the corrective saccades, the prevalence of saccades was statistically higher in the suppurative and cholesteatomatous chronic otitis media subgroups compared to the non-suppurative and control groups (p = 0.004).
The present study demonstrated that chronic otitis media is associated with a higher prevalence of vestibular symptoms and also a higher prevalence of changes in gain and corrective saccades when compared to controls.
近年来,科学证据表明慢性中耳炎可能导致平衡和前庭功能障碍。
比较慢性中耳炎患者和对照组的视频头脉冲试验(前庭眼反射增益和对称性以及隐蔽和显性扫视的存在)结果。
对慢性中耳炎患者(研究组)进行横断面研究,年龄在 18 至 60 岁之间。根据慢性中耳炎类型,研究组进一步分为(1)非化脓性、(2)化脓性和(3)胆脂瘤性。为了进行对比分析,我们选择了无耳和前庭疾病史的志愿者作为对照组,他们与研究组具有相同的纳入和排除标准。两组患者均行视频头脉冲试验。
研究组有 96 名志愿者,对照组有 61 名志愿者。研究组中 66%的患者有前庭症状,对照组中 3.2%的患者有前庭症状(p<0.001)。结果显示,慢性中耳炎组前庭眼反射增益变化(22.9%)和矫正扫视(12.6%)的发生率高于对照组(p<0.001)。尽管增益变化的发生率较高,但慢性中耳炎组的平均前庭眼反射增益仍在正常值范围内;然而,胆脂瘤性慢性中耳炎组在前半规管的平均前庭眼反射增益明显差于对照组(p<0.001)。关于矫正扫视,化脓性和胆脂瘤性慢性中耳炎亚组的扫视发生率明显高于非化脓性和对照组(p=0.004)。
本研究表明,与对照组相比,慢性中耳炎与前庭症状的发生率较高有关,并且增益和矫正扫视的变化发生率也较高。