Efüzyonlu Otitis Media' nın Pediatrik Yaş Grubunda Vestibüler Sistem Üzerindeki Etkisinin Tüp Tatbiki Öncesinde ve Sonrasında Bilgisayarlı Dinamik Posturografi Duyu Organizasyon Testi İle Değerlendirilmesi

Abstract

Kılıç, B., The Evaluation of the effect of the Otitis Media with effusion (OME) on the vestibular system of the pediatric age group with computerized dynamic posturography sensory organization test(CDP-SOT) before and after the ventilation tube insertion The aim of this study is to evaluate whether is there any difference between the pediatric patients with otitis media with effusion study group and the age and gender matched control group by means of vestibular system disorders and to find whether does the ventilation tube insertion have an effect on this patient group. At the same time, we also aim to evaluate the potential correlation between the dynamic balance tests and clinical static balance test results. Thus we both aim to contribute to the literature and assist the future possible studies in this field by comparing the results of this study with the current literature. Otitis media with effusion is one of the most common diseases of childhood. Although the most common clinical presentation of the otitis media with effusion is hearing loss, it may also cause balance problems in the pediatric age population. Even it is been speculated that otitis media with effusion is one of the most common etiologic factors of the vestibular problems and vertigo in the pediatric age population. Computerized dynamic posturography is a combined dynamic test protocol that quantitatively measures the patient’s balance control function in supine position by simulating the various surface and balance situations. In our study, we test the patient population both with the single leg stance test as a static clinical balance test and with the computerized dynamic posturography as an objective vestibular evaluation tool. We test the study group two times, the first one preoperatively and the second one post-operative second month. The control group has been tested once. Our study group consists of 30 pediatric age individuals (age varies between 4 and 12) and control group consists of 30 pediatric age individuals; total 60 patient included in this study. To look at the gender and age distributions separately within the groups; our study group consists of 21 male (%70), 9 female (%30) children. Mean age of the study group was 6,45; with a minimum age 4 years and 9 months and maximum age 11 years and 2 months. Control group consists of 18 male (%60) and 12 female (%40) patients, with the mean age of 6,2 (with minimum age 4 years and 10 months and maximum age 11 years and 5 months) There was a statistically significant difference between the study group’s condition 5, condition 6 and combined balance scores before the ventilation tube insertion and the control group’s condition 5, condition 6 and combined balance scores(Independent samples t test, p=0.008, p=0.024, p=0.038). There has been found a statistically significant relationship between the vestibular-associated symptoms and head impulse test (HIT) (p< 0.05). Most of those who describe symptoms (%87) was head impulse test (HIT) positive, but in all those who do not describe symptoms head impulse test was negative. The relationship between the single leg stance test results and the preoperative Sensory Organization Test (SOT) results (average balance score calculated separately for each 6 conditions and for combined balance score) was tried to be determined with the Pearson correlation test. There was found a positive and strong correlation between the single leg stance test results and the mean preoperative combined balance scores, preoperative condition 5 and preoperative condition 6 scores(((r= 0,744, r=0,752, r=0,766)). When study group’s preoperative and postoperative Sensory Organization Test ’s requirements and mean combined balance score values compared, the obtained mean condition 5, condition 6 and combined balance scores’ results were found statistically significant(p< 0,05). Clinicians should be aware of the possible negative impacts of the otitis media with effusion(OME) on the vestibular system in the pediatric age group, and also should be more illuminating to the parents about the vestibular and balance system symptoms accordingly. Thus, by inserting ventilation tubes, we may help to correct or reverse the possible negative impacts caused by the otitis media with effusion on the vestibular functions in the pediatric age group. Keywords: Otitis media with effussion, computerized dynamic posturography, pediatric vestibular disorders