Evaluation of the vestibulo-ocular reflex in patients with chronic otitis media

Andreza Tomaz, Rafael da Costa Monsanto, Flavia Salvaterra Cusin, Ana Luiza Papi Kasemodel, Norma de Oliveira Penido

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1 Scopus citations


Introduction: In recent years, scientific evidence has shown that chronic otitis media may cause balance and vestibular dysfunction. Objective: To compare the results of the video head impulse test (gain and symmetry of the vestibulo-ocular reflex and presence of covert and overt saccades) in patients with chronic otitis media and controls. Methods: Cross-sectional study of patients with chronic otitis media (study group), aged between 18 and 60 years. The patients in the study group were further divided according to the chronic otitis media type as (1) non-suppurative, (2) suppurative, and (3) cholesteatomatous. For the comparative analysis, we selected volunteers with no history of ear and vestibular diseases (control group), who met the same inclusion and exclusion criteria as the study group. Patients in both groups underwent a video head impulse test. Results: The study group consisted of 96 volunteers, and the control group of 61 individuals. The prevalence of vestibular symptoms was 66% in the study group and 3.2% in the control group (p < 0.001). The results show a higher prevalence of changes in the vestibulo-ocular reflex gain (22.9%) and corrective saccades (12.6%) in the chronic otitis media group compared to the control group (p < 0.001). Despite the higher prevalence of changes in gain, the average vestibulo-ocular reflex gains in the chronic otitis media groups were within the pre-defined values ​​of normality; however, the mean vestibulo-ocular reflex gain in the anterior semicircular canal was statistically worse in the cholesteatomatous chronic otitis media group compared to controls (p < 0.001). Regarding the corrective saccades, the prevalence of saccades was statistically higher in the suppurative and cholesteatomatous chronic otitis media subgroups compared to the non-suppurative and control groups (p = 0.004). Conclusion: The present study demonstrated that chronic otitis media is associated with a higher prevalence of vestibular symptoms and also a higher prevalence of changes in gain and corrective saccades when compared to controls.

Original languageEnglish (US)
Pages (from-to)675-682
Number of pages8
JournalBrazilian Journal of Otorhinolaryngology
Issue number5
StatePublished - Sep 1 2022
Externally publishedYes

Bibliographical note

Funding Information:
Three authors (AT, RCM, and ALPK) received a scholarship from the “ Coordenação de Aperfeiçoamento de Pessoal de Nível Superior , Brazil (CAPES)” (Finance Code 001).

Publisher Copyright:
© 2020 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial


  • Head impulse test
  • Otitis media
  • Semicircular canals
  • Vestibular function tests
  • Vestibulo-ocular reflex
  • Cross-Sectional Studies
  • Humans
  • Middle Aged
  • Otitis Media/complications
  • Head Impulse Test/methods
  • Young Adult
  • Adolescent
  • Adult
  • Vestibular Diseases/diagnosis
  • Reflex, Vestibulo-Ocular

PubMed: MeSH publication types

  • Journal Article


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