Role of vestibular testing in deciding treatment strategies for children with otitis media with effusion

BackgroundSeveral studies have indicated that during an episode of otitis media the child’s balance deteriorates and the child may become clumsy and fall more often.ObjectivesThe aim of this work was to assess the balance and vestibular system in children with otitis media with effusion prior to and after treatment.MethodsFifty children with bilateral OME (5–11 years old, 28 females and 22 males) were involved as a study group. The control group consisted of 30 healthy children age- and sex-matched (12 females/18 males). All subjects underwent Balance subset of Standardized Bruininks–Oseretsky test of motor proficiency (BOT-2), a test of static and dynamic balance and modified Clinical Test of Sensory Interaction for Balance (m-CTSIB) were done. Objective tests of vestibular end organ function including both Electronystagmography test ENG and both air conducted (AC) & bone conducted (BC) vestibular evoked myogenic potentials(VEMP) were recorded. These tests were performed two times: 1 day prior to and 4 weeks after management.ResultsOnly 8 children had history of vertigo or balance disorders. There were statistically significantly poorer scores in some balance subtest items of BOT-2 as in SOL with eye closed either on a line or on a balance beam as compared to the control group with significant improvement after management. Peripheral vestibular (ENG) abnormalities were recorded in 64% of children with statistically significant higher than the control group (10%) with significant improvement after management. Prior to treatment, AC-VEMPs were present in 12 (12%) ears while BC-VEMPs were recorded in 78 (78%) ears that mean ABG was 12.15 ± 2.75. After treatment most children showed nearly closure of ABG within 10 dB HL, AC-VEMPs were present in 72 (72%) ears and BC-VEMPs were recorded in 90 (90%) ears.ConclusionsRecurrent or persistent otitis media with effusion impairs the functioning of the vestibular system in children.