Abstract
The present study aimed to investigate the incidence and patterns of nystagmus in adult patients with acute otitis media (AOM) or otitis media with effusion (OME) without dizziness or vertigo, and discuss possible mechanisms. From February 2018 to November 2018, 34 consecutive patients with AOM or OME without dizziness were included. Nystagmus was examined with video Frenzel glasses. Of 34 adult AOM or OME patients without dizziness, nystagmus was observed in 28 patients (82%). In unilateral AOM or OME (n = 30), the most commonly observed nystagmus pattern was irritative-type direction-fixed nystagmus (n = 13), followed by paretic-type direction-fixed nystagmus (n = 8), and direction-changing positional nystagmus (n = 4). In bilateral AOM or OME (n = 4), direction-fixed nystagmus and direction-changing positional nystagmus were observed in two and one patients, respectively. Nystagmus was observed in as many as 82% of adult AOM or OME patients even though they did not complain of dizziness, and the pattern of nystagmus was either direction-fixed or direction-changing. Direct effect of inflammatory mediators penetrated from the middle ear and biochemical alteration in the inner ear fluids due to blood-perilymph barrier dysfunction may result in the presence of nystagmus in AOM or OME patients without dizziness.
Highlights
Otitis media with effusion (OME) is defined as the presence of fluid in the middle ear cavity without signs or symptoms of acute ear infection, and, in contrast, acute otitis media (AOM) is defined as the rapid onset of signs and symptoms of inflammation in the middle ear, most often with ear pain and a bulging eardrum [1]
In 21 patients with OME, 4 patients were within the age range of 20–40 years, 7 patients were within the age range of 41–60 years, and 10 patients were within the age range of 61–80 years
In 13 patients with AOM, 7 patients were within the age range of 20–40 years, 1 patients were within the age range of 41–60 years, and 5 patients were within the age range of 61–80 years (Table 1)
Summary
Otitis media with effusion (OME) is defined as the presence of fluid in the middle ear cavity without signs or symptoms of acute ear infection, and, in contrast, acute otitis media (AOM) is defined as the rapid onset of signs and symptoms of inflammation in the middle ear, most often with ear pain and a bulging eardrum [1]. While it has been reported that OME and AOM can cause balance disorders and have been considered the most common cause of vestibular disturbances and vertigo in pediatric patients. Findings of vestibular dysfunction including bithermal caloric results, spontaneous and positional nystagmus have been reported in limited number of adult AOM patients with vertigo [3, 22], and the presence of dizziness or vertigo is considered indicative of one of the intratemporal complications of AOM. Patients with OME or AOM complicated by mild vestibular disturbance may not complain of dizziness symptom
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