Assessment of Vestibular Function in Patients With Chronic Suppurative Otitis Media at the Kenyatta National Hospital

Abstract

Background: Chronic suppurative otitis media is a chronic inflammation of the middle ear and mastoid cavities. It may be associated with inner ear functional damage resulting in disorders of hearing and balance. The pathological factors which diffuse through the round window causing cochlear damage can also cause vestibular damage. Objective: This study evaluated the vestibular functions of patients presenting with Chronic suppurative otitis media at the Kenyatta National Hospital. Study Design and setting: This was a cross-sectional prospective study on patients presenting with Chronic suppurative otitis media at the Kenyatta National Hospital Ear Nose and Throat department. Methodology: Patients aged eighteen years and above who were recruited in the study were eighty. Convenient sampling technique was used to recruit participants. History and physical examination including pure tone audiometry were done followed by clinical vestibular assessment tests. Data Management and analysis: Data was expressed as means and standard deviation. Correlations of the variables and presence of vestibular disorders were established by use of chi squared test and odds ratios with a p value of <0.05 being significant. Results: Among eighty patients recruited into the study,15 (18.75%) had a positive history of vertigo. Patients with a vestibular disorder from the clinical vestibular tests done were 6(7.5%). There was spontaneous nystagmus and gaze evoked nystagmus in 2(2.5%) of the patients, abnormal dynamic visual acuity in 4(5%), head shaking nystagmus in 5(6.3%), positive head thrust test in 6(7.5%) and an abnormal fukuda step test in 5(6.3%) of the patients. Duration of disease, sensorineural type of hearing loss and a positive fistula test were the risk factors identified as associated factors to vestibular disorders. The mean duration of disease for the patients with vestibular disorders was 51.7±10.8 years while for those without vestibular disorders was 20.4±16.5 years with a p value <0.001. Patients who had a fistula test were 5(6.3%) all of whom were diagnosed with a vestibular disorder with a p value <0.001. Conclusion: Patients with a longer duration of CSOM, sensorineural hearing loss and a positive fistula test were more likely to develop vestibular disorders and should have routine vestibular assessment done................................................................................