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

Background: Several 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. Objectives: The aim of this work was to assess the balance and vestibular system in children with otitis media with effusion prior to and after treatment. Methods: Fifty 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. Results: Only 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. Conclusions: Recurrent or persistent otitis media with effusion impairs the functioning of the vestibular system in children.