[Balance disturbances in children with middle ear effusions]
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Updated: Oct 11, 2026

Behavioral Assessment of Hearing in 2 to 4 Year-old Children: A Two-interval, Observer-based Procedure Using Conditioned Play-based Responses
Published on: January 23, 2017
A Golz1, B Angel-Yeger, H Z Joachims
1Dept. of Otolaryngology and Head and Neck Surgery, Rambam Medical Center, Haifa.
Insights
Pediatric vertigo and dizziness, often linked to middle ear effusion (MEE), are frequently resolved by ventilation tube (VT) insertion. This study highlights MEE as a significant cause of childhood balance issues, with VT placement effectively restoring equilibrium.
Area of Science:
- Otolaryngology
- Pediatrics
- Neurology
Context:
- Vertigo and dizziness are underrecognized in children.
- Otitis media with middle ear effusion (MEE) is a common pediatric condition.
- Balance-related symptoms associated with MEE have been historically neglected.
Purpose:
- To objectively assess balance-related symptoms in children with chronic MEE.
- To evaluate the resolution of these symptoms after middle ear ventilation.
- To compare findings with a control group of healthy children.
Summary:
- Electronystagmography (ENG) and Bruininks-Oseretsky (BO) motor proficiency tests were used in 36 children (aged 4-9) with MEE before and after ventilation tube (VT) insertion.
- Abnormal ENG findings were present in 58% and low BO scores in 71% of children with MEE.
- In contrast, only 3 control children showed abnormal ENG, with one also having low BO scores.
Impact:
- Balance disturbances are frequently associated with chronic MEE in children.
- Middle ear ventilation via VT insertion effectively resolves these balance issues in most cases (96%).
- This underscores the importance of addressing MEE for pediatric balance and motor development.
Abstract:
Vertigo and dizziness are not common complaints in childhood, but probably present more often than has been thought. These symptoms, caused mainly by otitis media (OM) and middle ear effusion (MEE), are 2 of the most common diseases in children, and until recently had long been neglected in the literature and in practice. We determined objectively the incidence of balance-related symptoms in children with long-lasting MEE, and resolution following insertion of ventilation tubes (VT). 36 children, aged 4-9 years, were studied using electronystagmography (ENG) and the Bruininks-Oseretsky tests for motor proficiency, before and after ventilation of the middle ear. Results were compared to those in 74 healthy children with no history of middle ear disease. Abnormal ENG findings were found in 58%, and 71% had low Bruininks-Oseretsky (BO) test scores. The ENG was abnormal in only 3 of the controls, 1 of whom also had low BO test scores. The symptoms and signs of balance disturbances resolved in 96% following VT insertion. These results indicate that balance-related symptoms often encountered in young children may result from chronic MEE, and that they resolve following evacuation of the effusion and ventilation of the middle ear.
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