Intervention Principle In Revealing Latent Vestibular Disorders In Patients With Chronic Suppurative Otitis Media

Abstract

Research objective: to study and analyze vestibular disorders in patients with chronic
suppurative otitis media. Materials and research methods. The research included 41
patients with chronic suppurative otitis media (CSOM), admitted to the Department of
Congenital and Acquired ENT Diseases of the Republican Specialized Scientific and
Practical Medical Center of Pediatrics. Of them, 18 were women and 23 - men. 12 men
and 6 women underwent a conservative therapy. 29 patients underwent a surgical
treatment (17 men and 12 women). All patients underwent ENT examination, endootoscopy with video-recording, a set of audiological tests, complex vestibulometry using
the method of VNG, computed tomography of the temporal region, as well as clinical and
biochemical blood tests. Besides, for a detailed study of the vestibulo-anamnesis, a
questionnaire with a list of questions was proposed to the patients. Results and
Discussion. During the oto-endoscopic study from the total number of examined patients,
we revealed unilateral lesions in 34, and bilateral in 7 patients. Besides, 48 perforations
were detercted: mesotympanally - 33 ears, epitympanally - 12, epimesotympanally – 11
ears. During audiological examination (82 ears) conductive hearing loss was revealed in
17 (41.4%) patients, combined - in 13 (31.7%), which indicated lesions not only of the
middle ear, but also inclusion of the secondary neurosensory component due to the
involvement of the internal ear structures. Conductive hearing loss of I degree was
diagnosed in 7 patients, of II degree - in 10 patients. In other 13 cases (31.7%) hearing
dysfunction of III degree was diagnosed, which was of a combined nature of hearing loss.
During VNG study, spontaneous nystagmus was determined in 1 (2.4%) patient.
Peripheral spontaneous nystagmus in 4 cases was directed towards the healthy ear
(oppression) and towards the diseased ear (irritation); I and II degrees were noted in 3
patients, III degree - in 1 patient. Conclusion. The method of VNG revealed signs of
impairment of the peripheral parts of VS in 31.7% of patients who did not show obvious
subjective complaints of dizziness. All patients with CSOM are to undergo a complex
vestibulometric diagnostics in order to determine the vestibular status, the degree of the
internal ear structures involvement, prognosis, choice of tactics and prevention of
complications.