title: A Pilot Study to Assess the Vestibular Apparatus Function with Videonystagmography During Chronic Otitis Media with Effusion.
abstract: OBJECTIVE
  To assess the effect of chronic middle ear effusion (CMEE) on balance and equilibrium.
  
  
  METHODS
  Prospective study controlling two groups of children. The active arm consisted of children having a unilateral or bilateral CMEE that persisted for at least 3 months. The control group consisted of children presenting with normal middle ear. Children and parents in both groups were questioned about any symptom of vertigo, dizziness, disequilibrium or child's tendency to fall. ENT exam included an assessment with pneumatic and microscopic otoscopy, evaluation of the vestibular system with the Romberg test, the Fukuda test, the head-shaking test and the Starwalk test.
  
  
  RESULTS
  The study group consisted of 15 children (mean = 6.5 years, SD = 2; 10 females and 5 males). The control group consisted also of 15 children (mean = 7.2 years, SD = 1.8; 8 females and 7 males). The duration of MEE was between 3 and 12 months (mean = 8 months). Three children (20%) in the study group had a history of vertigo, imbalance, disequilibrium and/or tendency to fall. None of the children in the control group had such a history (p = 0.22); Five children in the study group had abnormal head-shaking test, Fukuda and/or Starwalk tests (33.33%). Two children in the control group had such a finding (13.33%) (p = 0.39). Romberg test was normal in all children in both groups. In the study group, one child showed positional and spontaneous nystagmus on VNG testing. Another one showed positional nystagmus. Hence, 2 children had abnormal findings on VNG (13.33%). In the control group, VNG was normal in all children (p = 0.46). Tympanometry showed a type B curve in 26 ears, a type C curve in 3 ears and type A in one ear. In the control group all patients presented a type A curve.
  
  
  CONCLUSIONS
  This paper describes the first study using VNG in a population of children with CMEE. The presence of balance disturbances associated or not with hearing loss is of paramount importance to the clinician as to the indications of myringotomy with a tube intervention.
authors.affiliation: University Hospital Center (CHU SJ), 3175, Cote Sainte-Catherine, Department of Otolaryngology, Montreal (QC) H3T 1C5, Canada. issam.saliba@umontreal.ca.
authors.forename: Issam
authors.initials: I
authors.lastname: Saliba
authors.forename: Chady
authors.initials: C
authors.lastname: Dagher
authors.forename: Elie
authors.initials: E
authors.lastname: El-Zir
authors.forename: Fady G
authors.initials: FG
authors.lastname: Yammine
mesh_terms: D000293:Adolescent; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008297:Male; D010034:Otitis Media with Effusion / Q000503:physiopathology*; D010865:Pilot Projects; D011446:Prospective Studies; D014722:Vestibule, Labyrinth / Q000503:physiopathology*; D014741:Video Recording