Evaluation of vestibular symptoms and postural balance control in patients with chronic otitis media

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

“…The major finding of this large observational study is that worse-ear hearing was identified as a risk factor for dizziness and disequilibrium in patients with COM. This is consistent with previous clinical observations [ 20 , 22 ], however the strongest evidence for combined cochlear-vestibular impairment secondary to COM comes from histopathological studies as described earlier [ 9 , 10 ]. Abnormalities in vestibular function tests are often detected in patients with COM who do not complain of vertigo/dizziness [ 8 ].…”

“…In the present study, over half of participants with COM (56.2%) reported at least mild inconvenience related to dizziness or disequilibrium. This was similar to participant responses in previous studies utilizing the COMQ-12 questionnaire [11,15,16,19] and other studies reporting the prevalence of vestibular symptoms in patients with COM (44-59.5%) [20][21][22][23][24]. Although participants could reasonably have other causes for their vestibular symptoms unrelated to COM, our results suggest that dizziness is a common burden in this population, which warrants further enquiry.…”

“…Considering our findings and that of other studies [20,22], future work should seek to determine whether a specific value for mean hearing thresholds across a range of frequencies in the affected ear(s) could predict which patients are most likely to suffer long-term vestibular sequelae secondary to COM. This would provide a transparent method and clinical justification for stratifying patients with non-cholesteatomatous middle ear disease for surgical intervention.…”

“…Taken together, it would appear that inflammatory damage to the inner ear is a chronic, slow process, thus allowing for adequate central compensation in daily situations. In such cases, subclinical vestibular deficits would only manifest symptomatically in challenging environments (e.g., disequilibrium in a dark environment) or during an acute episode of active middle ear inflammation [ 8 , 20 , 22 ]. Our findings suggest that patients with a greater degree of hearing impairment in the worse hearing ear are more likely to experience dizziness or balance problems.…”

Subjective Visual Vertical Testing in Patients With Chronic Suppurative Otitis Media

“…Michelson et al 22 and Pelosi et al 30 described that patients with utricular dysfunction usually complain of unspecific dizziness rather than vertigo, findings that were paralleled by ours. Although otolithic dysfunction often leads to milder symptoms than other causes of vestibular dysfunction 31 and may be adequately compensated by the central nervous system, 3 it may lead to (1) difficulties in maintaining postural stability in challenging situations 4,22,32,33 and (2) greater risk of falling, which correlates with high morbidity and mortality rates. 22,30,31 Our study has several limitations.…”