Presentation of dizziness in individuals with chronic otitis media: data from the multinational collaborative COMQ-12 study

Abstract

Purpose In chronic otitis media (COM), disease chronicity and severity of middle ear inflammation may influence the development of inner ear deficits, increasing the risk of vestibular impairment. This secondary analysis of the multinational collaborative Chronic Otitis Media Questionnaire-12 (COMQ-12) dataset sought to determine the prevalence of vestibular symptoms in patients with COM and identify associated disease-related characteristics. Methods Adult patients with a diagnosis of COM in outpatient settings at nine otology referral centers across eight countries were included. We investigated the presence of vestibular symptoms (dizziness and/or disequilibrium) using participant responses to item 6 of a native version of the COMQ-12. Audiometric data and otoscopic assessment were also recorded. Results This analysis included 477 participants suffering from COM, with 56.2% (n = 268) reporting at least mild inconvenience related to dizziness or disequilibrium. There was a significant association between air conduction thresholds in the worse hearing ear and presence of dizziness [adjusted odds ratio (AOR), 1.01; 95% CI 1.00–1.02; p = 0.0177]. Study participants in European countries (AOR 1.53; 95% CI 1.03–2.28; p = 0.0344) and Colombia (AOR 2.48; 95% CI 1.25–4.92; p = 0.0096) were more likely to report dizziness than participants in Asian countries. However, ear discharge and cholesteatoma showed no association with dizziness in the adjusted analyses. Conclusion Vestibular symptoms contribute to burden of disease in patients with COM and associates with hearing disability in the worse hearing ear. Geographical variation in presentation of dizziness may reflect financial barriers to treatment or cultural differences in how patients reflect on their health state.

Evaluation of postural stability and vestibulo-ocular reflex in adults with chronic suppurative otitis media

“…In our study, 52.3% of patients complained of dizziness. Our results are consistent with those of previous studies [ 12 – 14 ]. We used the DHI to quantify the severity of dizziness handicap in the patients.…”

“…However, vestibular test findings do not correlate well with patients’ clinical symptoms of dizziness [ 11 – 13 ]. Clinical evidence suggests that patients with chronic otitis media (COM) have a high probability of having vestibular dysfunction, which can negatively influence their quality of life [ 11 , 14 – 16 ]. The diagnosis of vestibular dysfunction in CSOM patients is often frustrating because the use of tap water in the caloric test is contraindicated in perforated tympanic membranes and substituted by an air caloric test [ 17 ].…”

Comparison of Disease-Specific, Generic, and Hearing-Specific Instruments Assessing Health-Related Quality of Life in Patients Undergoing Middle Ear Surgery for Chronic Otitis Media: A Prospective Correlational Study

“…Furthermore, there are many elements with respect to the rigorous psychometric evaluation of an HRQoL instrument that require consideration (15). As such, this study represents an additional perspective that complements previous work using the COMQ-12 (5,7,(16)(17)(18)(19).…”

“…In fact, Pearson correlation coefficient was higher for the COMQ-12 ( r = 0.46) than the HHI ( r = 0.41) postoperatively. The severity of certain disease-specific symptoms in COM, such as dizziness/balance problems, is influenced by the degree of hearing impairment (17) and may also improve with hearing restoration after surgical intervention, resulting in a larger change in overall disease-specific than hearing-specific HRQoL.…”

Quality of life after cholesteatoma surgery: comparison between surgical techniques

“…First, this is the first study comparing CWUT and CWDT with obliteration using the COMQ-12, a questionnaire that evaluates the QoL of patients in terms of disease activity, functional impairment and general impact on the life such as long-term GP attendance and medical treatments needed. In fact, the utility of the COMQ-12 in the evaluation of QoL of patients affected by middle ear disease has been recently demonstrated by a multinational collaboration 16 , 17 . In addition, in the present study the scores of the COMQ-12 questionnaire were correlated with the anatomical and functional results, demonstrating a strict relationship between the ABG and total and functional score of the COMQ-12.…”