Current evidence of peripheral vestibular symptoms secondary to otitis media

Rafael da Costa Monsanto, Ana Luiza Papi Kasemodel, Andreza Tomaz, Michael M. Paparella, Norma de Oliveira Penido

Research output: Contribution to journalArticlepeer-review

20 Scopus citations


Background: The association between otitis media and vestibular symptoms has been hypothesized in the past. Thus, in this study, we aimed to critically analyze (based in a systematic review of the literature) whether patients who have otitis media are at greater risk of developing vestibular impairment or not. Methods: We performed a systematic review of the literature and identified potentially relevant articles reporting vestibular symptoms and results of vestibular function tests in patients with otitis media through searches of the PubMED, Web of Science, Scopus, and Google Scholar databases. The quality of the final set of records was assessed using the “Newcaste–Ottawa Scale”. Results: Of the 2334 records searched, 43 met our inclusion and exclusion criteria, and those included 2250 patients. The records comprised 20 longitudinal studies, 21 cross-sectional studies, and 2 case reports. Regarding the type of otitis media studied, 25 examined vestibular impairment in otitis media with effusion, 6 acute otitis media, and 12 chronic otitis media. Results of anamnesis, clinical exams, and several vestibular function tests are reported and critically discussed. Conclusion: Most studies evaluating the association between otitis media and vestibular symptoms have potential methodological flaws. Clinical evidence suggests that patients with otitis media have increased chances for having vestibular symptoms, delayed acquisition of developmental milestones, and abnormalities in several vestibular function tests as compared with controls. Future studies with rigorous methodology aiming to assess the clinical significance (and prognostic factors) of the association between otitis media and vestibular impairment are warranted.Key message Several studies demonstrated long-term sequelae secondary to otitis media. However, the evidence supporting those assumptions are based in low-quality evidence. Thus, better structured studies are warranted to better understand the clinical relevance of such association.

Original languageEnglish (US)
Pages (from-to)391-401
Number of pages11
JournalAnnals of Medicine
Issue number5
StatePublished - Jul 4 2018

Bibliographical note

Funding Information:
The authors thank the “Coordenação de Aperfeiçoamento de Pessoal de Nível Superior” (CAPES) for the continued support; Thais Gomes Abrahao Elias for critically reviewing the manuscript; and Suzanne Schoenfelt for proofreading the manuscript.

Publisher Copyright:
© 2018, © 2018 Informa UK Limited, trading as Taylor & Francis Group.


  • complications
  • dizziness
  • inner ear
  • Otitis media
  • postural balance
  • vertigo
  • vestibular diseases
  • vestibular function tests


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