Abstract
PurposeIn chronic otitis media (COM), disease chronicity and severity of middle ear inflammation may influence the development of inner ear deficits, increasing the risk of vestibular impairment. This secondary analysis of the multinational collaborative Chronic Otitis Media Questionnaire-12 (COMQ-12) dataset sought to determine the prevalence of vestibular symptoms in patients with COM and identify associated disease-related characteristics.MethodsAdult patients with a diagnosis of COM in outpatient settings at nine otology referral centers across eight countries were included. We investigated the presence of vestibular symptoms (dizziness and/or disequilibrium) using participant responses to item 6 of a native version of the COMQ-12. Audiometric data and otoscopic assessment were also recorded.ResultsThis analysis included 477 participants suffering from COM, with 56.2% (n = 268) reporting at least mild inconvenience related to dizziness or disequilibrium. There was a significant association between air conduction thresholds in the worse hearing ear and presence of dizziness [adjusted odds ratio (AOR), 1.01; 95% CI 1.00–1.02; p = 0.0177]. Study participants in European countries (AOR 1.53; 95% CI 1.03–2.28; p = 0.0344) and Colombia (AOR 2.48; 95% CI 1.25–4.92; p = 0.0096) were more likely to report dizziness than participants in Asian countries. However, ear discharge and cholesteatoma showed no association with dizziness in the adjusted analyses.ConclusionVestibular symptoms contribute to burden of disease in patients with COM and associates with hearing disability in the worse hearing ear. Geographical variation in presentation of dizziness may reflect financial barriers to treatment or cultural differences in how patients reflect on their health state.Supplementary InformationThe online version contains supplementary material available at 10.1007/s00405-021-06993-1.
Highlights
Chronic otitis media (COM) is a common disease of the ear, affecting up to 2% of the global population [1]
In the logistic regression analysis, there was a significant association between worse-ear hearing and dizziness (AOR 1.01; 95% confidence intervals (95% CI) 1.00–1.02; p = 0.0177)
Based on data from a longitudinal, population-based cohort, Aarhus et al [25] demonstrated that childhood chronic suppurative otitis media (CSOM) and childhood hearing loss secondary to recurrent acute otitis media (AOM) are associated with an increased risk of dizziness in adulthood compared to adults with normal childhood hearing and a negative history of recurrent AOM
Summary
Chronic otitis media (COM) is a common disease of the ear, affecting up to 2% of the global population [1]. Common sequelae of COM include hearing loss, intermittent or persistent discharge through a perforated eardrum, and tinnitus. This has a negative impact on communication, academia, and employment, resulting in poor quality of life [3, 4]. Not the chief complaint, patients with COM frequently report vestibular symptoms including vertigo, postural instability, and disequilibrium [8]. Cadaveric studies of human temporal bones have demonstrated significant loss of both cochlear and vestibular hair cells in specimens from donors who had COM, providing histopathological evidence for inner-ear sequelae of chronic middle ear disease [9, 10]
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