Effect of surgery on vestibular system in pediatric patients with otitis media with effusion

The objectives of the study were to evaluate the effect of middle ear fluid aspiration and ventilation tube insertion in pediatric patients with chronic otitis media with effusion on the vestibular system using the video head impulse (vHIT) test and compare their results with healthy subjects.

The study population included two groups of subjects, a patient group and healthy subjects. The patient group consisted of 40 patients with bilateral chronic otitis media with effusion who underwent paracentesis, aspiration of the mucoid fluid from the middle ear, and placement of bilateral ventilation tubes. Tympanogram curves, vHIT gains, and the presence of saccades for each semicircular canal were documented before surgery, and the vHIT test was repeated on the 2nd day and the 1st and 2nd weeks postoperatively. All vHIT parameters were compared within the patient group and between patients and healthy subjects.

Preoperatively, patients with chronic otitis media with effusion had similar vHIT gains in all canals when compared with healthy subjects. In the patient group, 20 covert saccades were observed preoperatively, 11 on the 2nd day postoperatively, and 2 on the 1st week postoperatively, and all saccades were in the vertical canal planes. A significant decrease was detected between the number of preoperative and postoperative saccades in most of the vertical canal planes. No saccade was observed in healthy subjects.

Our results support that middle ear fluid drainage and ventilation tube placement might have a positive effect on the vestibular system, as all covert saccades disappeared at 2 weeks postoperatively.