Objective: To assess the effect of chronic middle ear effusion (CMEE) on balance and equilibrium.
Material and Methods: Prospective study controlling two groups of children. The active arm consisted
of children having a unilateral or bilateral CMEE that persisted for at least 3 months. The control group consisted of children
presenting with normal middle ear. Children and parents in both groups were questioned about any symptom of vertigo,
dizziness, disequilibrium or child’s tendency to fall. ENT exam included an assessment with pneumatic and microscopic
otoscopy, evaluation of the vestibular system with the Romberg test, the Fukuda test, the head-shaking test and the
Results: The study group consisted of 15 children (mean = 6.5 years, SD = 2; 10 females and 5 males). The control group
consisted also of 15 children (mean = 7.2 years, SD = 1.8; 8 females and 7 males). The duration of MEE was between 3
and 12 months (mean = 8 months). Three children (20%) in the study group had a history of vertigo, imbalance, disequilibrium
and/or tendency to fall. None of the children in the control group had such a history (p = 0.22); Five children in
the study group had abnormal head-shaking test, Fukuda and/or Starwalk tests (33.33%). Two children in the control
group had such a finding (13.33%) (p = 0.39). Romberg test was normal in all children in both groups. In the study group,
one child showed positional and spontaneous nystagmus on VNG testing. Another one showed positional nystagmus.
Hence, 2 children had abnormal findings on VNG (13.33%). In the control group, VNG was normal in all children (p =
0.46). Tympanometry showed a type B curve in 26 ears, a type C curve in 3 ears and type A in one ear. In the control
group all patients presented a type A curve.
Conclusion: This paper describes the first study using VNG in a population of children with CMEE. The presence of balance
disturbances associated or not with hearing loss is of paramount importance to the clinician as to the indications of
myringotomy with a tube intervention.