Long-Term Effects of Recurrent Acute Otitis Media on Balance and Vestibular Function in Pediatric Patients

Introduction: This study investigated the long-term impact of recurrent acute otitis media (rAOM) on balance and vestibular function in children. Methods: Overall, 55 children (25 males and 30 females) aged 8 years, with a documented history of rAOM, no AOM episodes in the past year, and no previous ear surgeries were assessed. Static posturography was used to evaluate postural instability by measuring sway area (SX, mm²) under four conditions: eyes open (EO) and eyes closed (EC), with and without foam pads. Vestibular function was assessed using the video head impulse test (v-HIT) to quantify vestibulo-ocular reflex (VOR) gain and corrective saccades across all six semicircular canals. Results: Children with a history of rAOM demonstrated significantly greater postural instability than healthy controls (p<0.001): 1) EO (SX, mm2): 557.9 ± 153.2 vs. 364.3 ± 201.2 2) EC (SX, mm2): 792.1 ± 275.0 vs. 564.4 ± 337.7 3) Pad EO (SX, mm2): 751.2 ± 235.7 vs. 445.4 ± 314.6 4) Pad EC (SX, mm2): 1032.4 ± 309.7 vs. 602.9 ± 442.0 The number of AOM episodes was the primary factor influencing balance dysfunction, with children who had more than 8 episodes showing the most pronounced deficits in postural stability (p < 0.05). In some cases, v-HIT revealed hypofunction in the right anterior (14.5%), left posterior (7.3%), left lateral (5.5%), left anterior (3.6%), and right posterior (3.6%) semicircular canals. Conclusions: Our findings suggest that rAOM can lead to persistent balance and vestibular dysfunction, highlighting the importance of early and accurate diagnosis, rehabilitation, and follow-up.