Results of Air Caloric and Other Vestibular Tests in Patients with Chronic Otitis Media

Abstract

ObjectivesAir caloric results are supposed to be influenced by anatomic changes of the middle ear. The aims of our study were to evaluate the incidence and characteristics of abnormal air caloric results in patients with unilateral chronic otitis media and without any history of vertigo, and to compare caloric results with there of other vestibular function tests (VFTs).MethodsTwenty five patients with unilateral chronic otitis media (COM) who were scheduled for surgery underwent VFTs preoperatively. Hearing was assessed using pure-tone audiometry and vestibular function was assessed using a set of VFTs: air caloric, head-shaking nystagmus (HSN), vibration-induced nystagmus (VIN), and subjective visual vertical (SVV) tests.ResultsSix patients (24%) showed pathologic canal paresis (CP) on COM-sided ears. Two patients showed pathologic CP on the contralateral side. However, both of the two showed inverted nystagmus to warm air stimulation on the COM-side and hyperactive nystagmus to cold air stimulation on the COM-side, which means that the COM-sided ear was stimulated too much. There was pathologic HSN in 12 patients (48%), pathologic VIN in 7 (28%), and pathologic SVV in 5 (20%). Overall, 20 (80%) patients showed abnormal findings through a set of VFTs. Patients with an interaural difference of bone-conduction hearing thresholds ≥10 dB tended to show more abnormal VFT results than those for whom the interaural difference of bone-conduction hearing thresholds was <10 dB.ConclusionOur data show that one-fourth of patients with unilateral COM show abnormal caloric results on the COM side. However, subclinical latent vestibular imbalances were found to be common, which might be related to the gradual vestibular involvement in inflammatory processes, regardless of the caloric results. Results of a set of VFTs should be referred to when determining vestibular imbalance in patients with COM.

Extended high‐frequency hearing loss following the first episode of otitis media

“…The association between threshold elevation in extended high‐frequencies (without hearing loss in standard audiometry) and tinnitus has been reported in the past . The correlation between otitis media and tinnitus, to our knowledge, has not been systematically studied in the past; nevertheless, it has been estimated that 18% to 43% of patients with chronic otitis media complain of tinnitus during the evolution of the disease This number may, however, increase up to 79% when considering patients who have associated vestibular symptoms . Park et al, in a study involving eight subjects who showed sensorineural hearing loss in standard audiometry following acute otitis media, found tinnitus in 87.5% of these patients.…”

Evaluation of Vestibular Function in Patients with Chronic Suppurative Otitis Media

“…This may be due to gradual vestibular compensation [9]. Rotatory chair abnormalities were reported in 70.1% of the patients, caloric weakness was found in 61.6% and VEMPs were abnormal in 23.3% [9,10,12,13]. Moreover, the relationship between vertigo and SNHL (57.1%) was just close to statistical significance [1,3].…”

Clinical evaluation of inner ear changes as result of chronic otitis media and its surgery

“…Lee et al [22] demonstrated that despite any complaint of definite vestibular symptoms, an high incidence of vestibular impairment in patients with unilateral COM was observed.…”