Vestibular Screening in Pediatric Patients with Otitis Media

Abstract

Otitis media with effusion (OME) is a common cause of vestibular disturbances in children. However, young children often lack the language to express their symptoms, and it is uncommon to screen children for vestibular impairments.The purpose of this study was to develop a screening protocol for children presenting with OME to determine if diagnostic vestibular testing is necessary.Children with normal hearing (NH), sensorineural hearing loss (SNHL), and conductive hearing loss (CHL) due to OME participated in a vestibular screening.There were 30 participants, ages four to eight years, ranging from 48 to 101 months included in the study: 10 with NH, 11 with CHL due to OME, and 9 with SNHL.The vestibular screening consists of patient and parent questionnaires and a functional evaluation. The tests examined coordination, balance, oculomotor function, and nystagmus.Those with CHL were significantly more likely to display abnormal smoothness of pursuit, as measured with observations for rapid tracking, absence of or delayed saccades, and overshoot, than those with NH or SNHL (p = 0.012). Parents of children with CHL due to OME were more likely to report their child experiencing middle ear pressure than the parents of children with NH or SNHL (p = 0.010). In addition, children with CHL were less likely to report hearing loss than those with NH or SNHL. Parent and patient report were not found to be reliable indicators of vestibular disturbances.This pilot study suggests that children with CHL due to OME present with more oculomotor abnormalities than their peers with NH. Further research is necessary to determine validity and reliability of the findings for this present study.

Vestibular assessment in children aged zero to twelve years: an integrative review

“…After analyzing all the studies included in the integrative review, eight experimental studies were found, six of which were randomized clinical trials (level of evidence 2) 12 , 13 , 14 , 15 , 16 , 17 and two non-randomized ones (level of evidence 3) 18 , 19 ; eighteen observational studies (level of evidence 4) 5 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 ; and six case studies (level of evidence 5), 36 , 37 , 38 , 39 , 40 , 41 according to the classification used. 11 …”

Evaluation of vestibular function in children with purulent media otitis by computer stabilometry

“…Acute otitis media is a fairly common pathological process of the middle ear among preschool children [13,14]. Previous studies have revealed symptoms of latent vestibular pathology in children with secretory otitis media [14,18,19,21]. However, only a small number of these studies focus on a narrow age range -preschool age [16,17].…”

“…The study of coordination, balance, oculomotor function and nystagmus in children 4-8 years with otitis media with effusion revealed a significant increase in oculomotor abnormalities compared with the control [18]. A study of 4-15-year-old children with otitis media with effusion and dizziness by video pulse vestibulo-ocular test (vHIT) did not reveal significant changes in the mean values of vHIT growth or their asymmetry, however, revealed an increased frequency of latent saccades (57 %), which was considered by the authors as a sign of mild vestibular disorder [19].…”

Middle ear pathologies in children living with HIV: A scoping review

“…The WHO has stipulated that approximately 50% of individuals with acute otitis media (AOM) will develop chronic suppurative otitis media (CSOM) (Mahy et al, 2019 ). Further complications of untreated middle ear pathologies include permanent hearing impairment (Hutz et al, 2018 ), meningitis (Avnstorp et al, 2016 ), facial paralysis (Lawler, 2018 ), and vestibular disturbances (Rehagen et al, 2019 ). The impacts of these conditions in children can have far-reaching consequences.…”