Effects of Middle Ear Effusion on the Vestibular System in Children

Abstract

Vertigo and dizziness are not common in childhood, but are probably present more often than was formerly thought. These symptoms caused mainly by otitis media and middle ear effusion, two of the most common diseases in children, have been neglected for a long time, both in the literature and in practice, until recently. The purpose of this study was to determine objectively the incidence of balance-related symptoms in children with long-lasting middle ear effusion and to discover whether these symptoms resolve after the insertion of ventilation tubes. One hundred thirty-six children, ages 4 to 9 years, were given electronystagmographic tests and the Bruininks-Oseretsky tests for motor proficiency before and after tube ventilation of the middle ear. The results were compared with those in 74 healthy children with no history of middle ear diseases. Pathologic findings were found in 58% of the children with chronic middle ear effusion, as compared with only 4% of the control group. The symptoms and signs of balance disturbances resolved in 96% of the children after ventilation tube insertion. The results of this study indicate that balance-related symptoms often encountered in young children may result from chronic middle ear effusion and that these symptoms will resolve after evacuation of the effusion and ventilation of the middle ear.

Clinical Practice Guideline: Tympanostomy Tubes in Children

“…OME has a direct and reversible impact on the vestibular system. [69][70][71][72][73] Children with chronic OME have significantly poorer vestibular function and gross motor proficiency when compared with non-OME controls. Moreover, these deficiencies tend to resolve promptly following tympanostomy tube insertion, although 1 case-control study did not show vestibular benefits with rotational chair testing.…”

Vertigo and balance problems in children—An epidemiologic study in Finland

“…Migraine headache in children usually occurs in the frontal or periorbital region, lasts often less than 2 h and it is associated with vertigo, nausea, vomiting and visual disturbance [12]. Balance disorder related with otitis media with effusion will resolve, following the insertion of ventilation tubes [13][14][15].…”

Toll-Like Receptor 2-Dependent NF-κB Activation Is Involved in Nontypeable Haemophilus influenzae -Induced Monocyte Chemotactic Protein 1 Up-Regulation in the Spiral Ligament Fibrocytes of the Inner Ear

“…Antibiotics have led to a dramatic decline in the incidence of life-threatening complications of otitis media (OM), such as meningitis or brain abscess (3). However, inner ear dysfunction secondary to chronic OM, including high-frequency sensorineural hearing loss or vertigo, is not uncommon (13,26,36,55,60). Although chronic middle ear inflammation is believed to cause inner ear dysfunction by entry of OM pathogen components or cytokines from the middle ear into the inner ear, the underlying mechanisms are not well understood (18,32,39,44,52,87).…”