An evaluation of postural stability and the effects of middle-ear drainage on vestibulo-spinal reflexes of children with chronic otitis media with effusion

Int J Pediatr Otorhinolaryngol. 2004 Sep;68(9):1175-9. doi: 10.1016/j.ijporl.2004.03.017.

Abstract

Objective: Many authors agree that chronic otitis media with effusion (OME) are the main causes of vertigo and balance disturbances in children. The aim of this work was the stabilometric evaluation of postural stability and the influence of middle ear drainage on vestibulo-spinal reflexes in children with OME.

Methods: Fifteen children with OME (5-14 years old, 13 males and two females) were selected for bilateral drainage of the middle ear after conservative treatment proved ineffective. The control group consisted of 15 healthy children of an analogous age range. Static and quasi-dynamic posturography was performed to evaluate balance. The tests were performed three times: 1 day before drainage, 1 day after drainage and 4 weeks after drainage. Parameters including the field of the developed area and the average velocity of body deflection were analysed.

Results: There was statistically significant elevation of stabilogram parameters in almost all the tests in children with OME as compared to the control group. The changes in the stabilogram parameters were analysed with reference to the timing of the evaluation. Significant improvement was noted after the fluid was removed from the ear, although recovery was not complete after 4 weeks.

Conclusions: The presence of fluid in the middle ear impairs the functioning of the balance system in children. Postural stability and the quantity of vestibulo-spinal reflexes seem to depend on the functional condition of the middle ear. Prolonged cases of OME could potentially handicap a child's motor development.

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Drainage
  • Female
  • Humans
  • Male
  • Middle Ear Ventilation / instrumentation*
  • Otitis Media with Effusion / epidemiology*
  • Otitis Media with Effusion / physiopathology
  • Otitis Media with Effusion / therapy*
  • Postural Balance*
  • Reflex, Vestibulo-Ocular / physiology*
  • Severity of Illness Index
  • Spine / physiology*
  • Treatment Outcome
  • Vertigo / diagnosis
  • Vertigo / epidemiology*