Video head impulse and suppression head impulse test in chronic otitis media patients

Chronic otitis media (KOM), one of the most common ear diseases among otolaryngological diseases, is one of the most important causes of chronic hearing loss. KOM is the inflammation of the mucosa covering the air spaces of the middle ear and temporal bone for more than 3 months. KOM causes structural and functional damage in the cochlea. Inflammatory mediators and bacterial products formed as a result of KOM may cause damage to the organ of Corti and hearing-related structures in the cochlea by advancing into the labyrinth through the round window. Dizziness and balance problems are also seen in patients as a result of the vestibular system structures being affected due to its anatomical proximity. Videonystagmography (VNG), caloric test, vestibular evoked potentials (VEMP) tests are used to evaluate vestibular involvement and damage in KOM patients. However, there are some difficulties and limitations in the clinical application of these tests. The video head impulse test (VHIT), which is used to evaluate the vestibular system functions, has been increasingly used in recent years due to its ease of use and the important information it provides about the vestibular system. The VHIT test is used to evaluate the functions of the three semicircular canals (SSK) in the vestibular system. Since the VHIT test is not affected by middle ear pathologies, it is not limited to use in the KOM patient group like other tests. In our study, we aimed to evaluate the results of VHIT and SHIMP in KOM patients and to investigate the correlation between balance disorders. In our study, as we expected, the values of the right and left ear airway 250 Hz, 500 Hz, 1000 Hz, 2000 Hz, 4000 Hz, 6000 Hz and 8000 Hz of the patients in the patient group were found to be statistically significantly higher than those in the control group (respectively; p=0.001; p=0.001; p=0.001; p=0.001; p=0.001; p=0.001; p=0.001; p<0.01). No loss of gain was observed in the lateral canal in KOM patients and the control group. Moreover, there was no statistically significant difference between the Video Head Impulse test Gains of the cases according to the groups (p>0.05). The mean values of Left Lateral Gain measurements of the patients were found to be 0.86±0.06, and the mean values of Right Lateral Gain measurements were found to be 0.89±0.06. In the SHIMP test, the Left and Right Lateral Gain measurement values of the patients in the patient group were found to be statistically significantly higher than those in the control group (p=0.001; p=0.007; p<0.01). In our study, no overt and covert saccade were found in the VHIT test, and the left and right lateral overt saccade amplitude measurement values of the subjects in the control group in the SHIMP test were found to be statistically significantly higher than those in the patient group (p=0.001; p=0.004; p<0.01). According to the findings we obtained as a result of our study, lateral canal mean gains did not differ significantly in chronic otitis patients when compared to the control group. Although there is no statistically significant difference in the mean gains of the lateral canals when the patients are compared with the control group, it is thought that these canals may also be affected in chronic otitis patients. This study, in which VOR gain values are calculated for vestibular channels one by one and for each channel in patients with chronic otitis media, is thought to be a guiding study for the effective use of v-HIT test in patients with chronic otitis media.