Results of Air Caloric and Other Vestibular Tests in Patients with Chronic Otitis Media

이인식; 신정은; 이여진; 박홍주; 정용수; 곽희붕

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자료유형: 학술저널

저자정보: 이인식 신정은 이여진 박홍주 정용수 곽희붕

저널정보: 대한이비인후과학회 Clinical and Experimental Otorhinolaryngology Clinical and Experimental Otorhinolaryngology 제2권 제3호

발행연도: 2009.1

수록면: 145 - 150 (6page)

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Objectives. Air caloric results are supposed to be influenced by anatomic changes of the middle ear. The aims of our study were to evaluate the incidence and characteristics of abnormal air caloric results in patients with unilateral chronic otitis media and without any history of vertigo, and to compare caloric results with there of other vestibular function tests (VFTs). Methods. Twenty five patients with unilateral chronic otitis media (COM) who were scheduled for surgery underwent VFTs preoperatively. Hearing was assessed using pure-tone audiometry and vestibular function was assessed using a set of VFTs: air caloric, head-shaking nystagmus (HSN), vibration-induced nystagmus (VIN), and subjective visual vertical (SVV) tests. Results. Six patients (24%) showed pathologic canal paresis (CP) on COM-sided ears. Two patients showed pathologic CP on the contralateral side. However, both of the two showed inverted nystagmus to warm air stimulation on the COM-side and hyperactive nystagmus to cold air stimulation on the COM-side, which means that the COM-sided ear was stimulated too much. There was pathologic HSN in 12 patients (48%), pathologic VIN in 7 (28%), and pathologic SVV in 5 (20%). Overall, 20 (80%) patients showed abnormal findings through a set of VFTs. Patients with an interaural difference of bone-conduction hearing thresholds ≥10 dB tended to show more abnormal VFT results than those for whom the interaural difference of bone-conduction hearing thresholds was <10 dB. Conclusion. Our data show that one-fourth of patients with unilateral COM show abnormal caloric results on the COM side. However, subclinical latent vestibular imbalances were found to be common, which might be related to the gradual vestibular involvement in inflammatory processes, regardless of the caloric results. Results of a set of VFTs should be referred to when determining vestibular imbalance in patients with COM.

#Chronic otitis media #Caloric #Vibration #Subjective visual vertical #Head shaking

참고문헌 (24)

참고문헌 신청

Barber HO / 1978 / Air caloric stimulation with tympanic membrane perforation / Laryngoscope 88 (7) : 1117 ~ 1126

Bohmer A / 1995 / The subjective visual vertical as a clinical parameter of vestibular function in peripheral vestibular diseases / J Vestib Res 5 (1) : 35 ~ 45

Casselbrant ML / 1995 / Effect of otitis media on the vestibular system in children / Ann Otol Rhinol Laryngol 104 (8) : 620 ~ 624

Gianoli GJ / 2008 / Chronic suppurative otitis media, caloric testing, and rotational chair testing / Otol Neurotol 29 (1) : 13 ~ 15

Goldstein NA / 1998 / Intratemporal complications of acute otitis media in infants and children / Otolaryngol Head Neck Surg 119 (5) : 444 ~ 454

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