Journal of Shanghai Jiao Tong University (Medical Science) >

2021 , Vol. 41 >Issue 7: 910 - 914

DOI: https://doi.org/10.3969/j.issn.1674-8115.2021.07.010

Clinical research

Preliminary analysis of vestibular function in patients with eosinophilic otitis media

  • Yue ZHOU ,
  • Peng-jun WANG ,
  • Hui WANG ,
  • Dong-zhen YU ,
  • Zheng-nong CHEN ,
  • Ya-qin WU ,
  • Hai-bo SHI
Expand
  • Department of Otolaryngology-Head & Neck Surgery, Shanghai Sixth People's Hospital, Otolaryngology Institute, Shanghai Jiao Tong University, Shanghai 200233, China

Online published: 2021-08-03

Supported by

Shanghai Municipal Education Commission—Gaofeng Clinical Medicine Grant Support(20152233);Leading Talents in Shanghai(2017062);Innovative Research Team of High-Level Local Universities in Shanghai(SSMU-ZLCX20180602)

Fold

Abstract

Objective

·To discuss the effect of eosinophilic otitis media (EOM) on vestibular function.

Methods

·Data of 8 EOM patients (EOM group) were collected. Additionally, 16 cases of chronic suppurative otitis media (CSOM group) and 16 healthy volunteers (control group) matched with age, gender and course of disease were selected for comparison. All participants were monitored by pure-tone test, acoustic impedence, video head impulse test (vHIT), vestibular evoked muscular potential (VEMP), and dynamic posturography (DPG). And then, date of the three groups were analyzed.

Results

·Compared with the control group, there was a statistically significant difference in the composition ratio of the types of hearing loss in the EOM group (P=0.000), while there was no significant difference in the composition ratio between the EOM group and the CSOM group (P=0.892). In vHIT, the gain values of semicircular canals in the EOM group were significantly different from those of the CSOM group (P=0.035), without visible difference from those of the control group (P=0.220). The gain values of upper and posterior semicircular canals in the EOM group were not significantly different from those in both the CSOM group and control group (P=0.807, P=0.971, P=0.683, P=0.610). In cVEMP and oVEMP, the abnormal rate of the EOM group was significantly higher than that of the control group (P=0.002, P=0.033), while being compared with the CSOM group, there was no significant difference (P=0.631, P=0.352). In cVEMP, the incubation periods of P1 and N1 in the EOM group were significantly longer than those in the control group (P=0.000, P=0.000) , and the amplitudes of P1-N1 in the EOM group were lower than those in the control group and CSOM group (P=0.000, P=0.000). In DPG, the composite score (P=0.025), visual score (P=0.017), vestibular score (P=0.040) and visual preference score (P=0.006) of the EOM group were significantly lower than those in the control group. And the composite score of the EOM group was also obviously lower than the CSOM group (P=0.024).

Conclusion

·EOM tends to lead to more severe inner ear neurotoxicity than neutrophil-mediated infective middle ear inflammation. Since vestibular dysfunction has the characteristics of compensatory remission, patients with EOM may not have obvious symptoms of vertigo. Systematic and comprehensive assessment of vestibular function is helpful to reveal functional disability, and then targeted rehabilitation therapy can be carried out.

Key words： eosinophilic otitis media; impairment of vestibular function; toxicity of the inner ear

Cite this article

Yue ZHOU , Peng-jun WANG , Hui WANG , Dong-zhen YU , Zheng-nong CHEN , Ya-qin WU , Hai-bo SHI . Preliminary analysis of vestibular function in patients with eosinophilic otitis media[J]. Journal of Shanghai Jiao Tong University (Medical Science), 2021 , 41(7) : 910 -914 . DOI: 10.3969/j.issn.1674-8115.2021.07.010

References

1 Tomioka S, Kobayashi T, Takasaka T. Intractable otitis media in patients with bronchial asthma (eosinophilic ottis media) [C]//Sanna M. Cholesteatoma and mastoid surgery. Rome: CIC Edizioni Internationali, 1997: 851-853.
2 Lara-Sánchez H, Vallejo LA. Eosinophilic otitis media[J]. N Engl J Med, 2017, 376(7): e10.
3 Iino Y, Tomioka-Matsutani S, Matsubara A, et al. Diagnostic criteria of eosinophilic otitis media, a newly recognized middle ear disease[J]. Auris Nasus Larynx, 2011, 38(4): 456-461.
4 中华医学会耳鼻咽喉头颈外科学分会耳科学组, 中华耳鼻咽喉头颈外科杂志编辑委员会耳科组. 中耳炎临床分类和手术分型指南(2012)[J]. 中华耳鼻咽喉头颈外科杂志, 2013, 48(1): 5.
5 王鹏军, 周月, 王慧, 等. 鼓室分泌物涂片阴性的嗜酸粒细胞性中耳炎1例及文献复习[J]. 临床耳鼻咽喉头颈外科杂志, 2020, 34(5): 465-467.
6 张玉忠, 陈耔辰, 徐勇, 等.嗜酸粒细胞性中耳炎一例[J].中华耳鼻咽喉头颈外科杂志, 2017, 52(9): 707-709.
7 Neff BA, Voss SG, Carlson ML, et al. Treatment of eosinophilic otitis media with pegylated interferon?α 2a and 2b[J]. Laryngoscope, 2017, 127(5): 1208-1216.
8 Matsubara A, Nishizawa H, Kurose A, et al. An experimental study of inner ear injury in an animal model of eosinophilic otitis media[J]. Acta Otolaryngol, 2014, 134(3): 227-232.
9 孙爱华. 耳聋的临床诊断与治疗[J]. 中华临床医师杂志(电子版), 2012, 6(2): 277-281.
10 Jerger J. Clinical experience with impedance audiometry[J]. Arch Otolaryngol, 1970, 92(4): 311-324.
11 于澜, 赵苗苗, 李清溪, 等. EMG修正对颈部及眼部前庭诱发肌源性电位的影响[J]. 中华耳科学杂志, 2017,15(02):147-152.
12 钟雅琴, 罗斌, 管锐瑞, 等. 前庭神经炎患者的前庭功能分析[J]. 听力学及言语疾病杂志, 2019, 27(4): 358-363.
13 刘建国, 郭素英, 王琨, 等. 眼震电图与动态姿势图在良性阵发性位置性眩晕中的临床应用[J]. 临床耳鼻咽喉头颈外科杂志, 2012, 26(7): 289-292.
14 Mofatteh MR, Shahabian Moghaddam F, Yousefi M, et al. A study of bacterial pathogens and antibiotic susceptibility patterns in chronic suppurative otitis media[J]. J Laryngol Otol, 2018, 132(1): 41-45.
15 Monsanto RDC, Kasemodel ALP, Tomaz A, et al. Evaluation of vestibular symptoms and postural balance control in patients with chronic otitis media[J]. J Vestib Res, 2020, 30(1): 35-45.
16 Mostafa BE, Shafik AG, El Makhzangy AM, et al. Evaluation of vestibular function in patients with chronic suppurative otitis media[J]. ORL J Otorhinolaryngol Relat Spec, 2013, 75(6): 357-360.
17 Iino Y, Kakizaki K, Katano H, et al. Eosinophil chemoattractants in the middle ear of patients with eosinophilic otitis media[J]. Clin Exp Allergy, 2005, 35(10):1370-1376.
18 Esu Y, Tamii S, Masuda M, et al. Effectiveness of myringoplasty in patients with eosinophilic otitis media[J]. Auris Nasus Larynx, 2021, 48(3): 368-376.
19 Esu Y, Iino Y, Masuda M, et al. Proposal of a treatment strategy for eosinophilic otitis media based on middle ear condition[J]. Otol Neurotol, 2018, 39(8): e671-e678.
Options
Outlines

/

〈 〉