Evaluation of vestibular functions with video head impulse test in patients with chronic otitis media

Objective: Chronic otitis media (COM), can be associated with functional damage to the inner ear resulting in sensorineural hearing loss (SNHL) and dizziness. Published incidence rates of dizziness range from 40% in patients with cholesteatoma and 54% in cases of chronic suppurative otitis media. The clinical effects of vestibular damage are not widely reported and are extremely variable. The purpose of this study was to evaluate the results of vestibular function testing for patients with COM by video head impulse test. Material and Methods: Thirty patients who diagnosed unilateral COM and a control group of 30 men participated in this study between January, 2007 and November, 2009. The patients underwent a full otolaryngologic examination and otoscopic examinations with automicroscopy. Audiometry and temporal bone computerized tomography examinations were also performed. Patients divided 3 groups as simple COM, mucosal COM and COM with cholesteatoma considering their otoscopic and radiologic examination. For vestibular system evaluation, all subjects underwent v-HIT for all 6 semicircular canals. In addition, to evaluate the effect of vestibular system pathology on quality of life, Diziness Handicap Inventory (DHI) was performed for all participants. Results: Pathologic v-HIT was detected in 11 (36.7%) of 30 patients in the chronic otitis media group and was detected in 2 (6.7%) of 30 participants in the control group. Patients with COM had significantly higher proportions of semicircular canal deficit than those in the control group. There was a statistically significant difference for the mean gain of lateral channels between patient and control groups in v-HIT, but no statistically significant difference was found in the mean gain of the anterior and posterior channels when groups were compared. There was also statistically significant difference for the mean gain of lateral channels when compared simple COM and cholesteatom groups. Conclusion: In the present study we found that the vestibular system is significantly affected in cases with COM. As vertigo and instability can negatively affect patients' quality of life, assessment of vestibular function should be part of the functional evaluation of patients with COM. vHIT can provide a practical method of assessing the vestibular function in patients with chronic middle ear pathology. V-HIT is more advantageous for patients with COM because of not affected by middle ear pathologies and can evaluate all six semicircular channels. Key words: Chronic otitis media (COM), Video Head Impulse Test (v-HIT), cholesteatoma