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复发性急性中耳炎对儿童平衡和前庭功能的长期影响。

Long-Term Impact of Recurrent Acute Otitis Media on Balance and Vestibular Function in Children.

作者信息

Aldè Mirko, Bosi Pietro, Muck Stefanie, Mayr Thomas, Di Mauro Paola, Berto Valentina, Aleandri Beatrice Gaia, Folino Francesco, Barozzi Stefania, Zanetti Diego, Marchisio Paola

机构信息

Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy.

Audiology Unit, Department of Specialist Surgical Sciences, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy.

出版信息

Brain Sci. 2024 Dec 12;14(12):1246. doi: 10.3390/brainsci14121246.

Abstract

BACKGROUND/OBJECTIVES: Recurrent acute otitis media (rAOM) is a common disease in childhood, but its impact on the vestibular system remains poorly understood. The present study aimed to evaluate the long-term effects of rAOM on balance and vestibular function in pediatric patients.

METHODS

A total of 55 children, aged 8 years (25 males and 30 females), with a documented history of rAOM, no AOM episodes in the past year, and no previous ear surgery were assessed. Static posturography was used to assess postural instability, measuring sway area (SX, mm) under four conditions: eyes open and eyes closed, with and without foam pads. Vestibular function was evaluated using the video head impulse test (v-HIT) to quantify vestibulo-ocular reflex (VOR) gain and corrective saccades across all six semicircular canals.

RESULTS

Children with a history of rAOM demonstrated significantly greater postural instability than healthy controls ( < 0.001 for all test conditions). The number of AOM episodes was the primary factor influencing balance dysfunction, with children who had more than eight episodes showing the most pronounced deficits in postural stability ( < 0.05). In some cases, the v-HIT revealed hypofunction in the right anterior (14.5%), left posterior (7.3%), left lateral (5.5%), left anterior (3.6%), and right posterior (3.6%) semicircular canals.

CONCLUSIONS

The results of this study suggest that rAOM can lead to lasting balance and vestibular dysfunction, highlighting the importance of early monitoring and potential rehabilitation.

摘要

背景/目的:复发性急性中耳炎(rAOM)是儿童期的常见疾病,但其对前庭系统的影响仍知之甚少。本研究旨在评估rAOM对儿科患者平衡和前庭功能的长期影响。

方法

共评估了55名8岁儿童(25名男性和30名女性),他们有rAOM病史,过去一年无急性中耳炎发作,且既往无耳部手术史。采用静态姿势描记法评估姿势不稳,测量在四种条件下的摆动面积(SX,mm):睁眼和闭眼,有和没有泡沫垫。使用视频头脉冲试验(v-HIT)评估前庭功能,以量化所有六个半规管的前庭眼反射(VOR)增益和矫正扫视。

结果

有rAOM病史的儿童比健康对照组表现出明显更大的姿势不稳(所有测试条件下P<0.001)。急性中耳炎发作次数是影响平衡功能障碍的主要因素,发作次数超过8次的儿童姿势稳定性缺陷最为明显(P<0.05)。在某些情况下,v-HIT显示右前半规管(14.5%)、左后半规管(7.3%)、左外侧半规管(5.5%)、左前半规管(3.6%)和右后半规管(3.6%)功能减退。

结论

本研究结果表明,rAOM可导致持久的平衡和前庭功能障碍,凸显了早期监测和潜在康复的重要性。

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