Kronik Süpüratif Otitis Medialı Erişkinlerde Postüral Stabilite Ve Vestibülooküler Refleksin Değerlendirilmesi
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Tarih
2024
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Necmettin Erbakan Üniversitesi, Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Kronik süpüratif otitis media (KSOM) tanılı hastalarda Video Head Impulse Test (vHIT) ve postürografi testleri ile vestibülo-oküler refleks ve postüral stabilite değerlendirilerek KSOM'un vestibuler fonksiyona etkisi incelendi.
Gereç ve Yöntem: Araştırma, Nisan 2023-Aralık 2023 tarihleri arasında Kulak Burun Boğaz polikliniğine gelen KSOM hastalarına uygulandı. Araştırmanın örneklemi18-65 yaş arası KSOM hastalarından oluşturuldu. NEÜ Tıp Fakültesi Kulak Burun Boğaz hastalıkları polikliniğine gelen KSOM tanısı alan 51 gönüllü katılımcı çalışma grubu olarak seçildi. Normal işitme ve dengeye sahip 40 gönüllü katılımcıdan kontrol grubu oluşturuldu. Her hastaya kulak burun boğaz muayenesi yapıldıktan sonra saf ses odyometri testi ile hava ve kemik yolu eşikleri değerlendirildi. Vestibüler sistemin değerlendirilmesi Video Head Impulse Testi (vHIT) ve Postürografi ile yapıldı. Çalışmaya katılan tüm bireylere vestibüler testlerin başlangıcından önce yaş, cinsiyet, eğitim durumu, tıbbi geçmiş ve kullanılan ilaçlar vb. gibi demografik bilgiler, her katılımcı için ayrı ayrı demografik bilgi formuna kaydedildi. Her katılımcıya baş dönmesi engellilik envanteri (BEE) (Dizziness Handicap Inventory) uygulandı.
Bulgular: Çalışmaya katılan hasta grubunun 34’ü (%66,7) kadın, 17’si (%33,3) erkek; kontrol grubunun ise 25’i (%64,3) kadın, 15’i (%35,7) erkek idi. vHIT VOR kazancı değerleri açısından kontrol ve hasta grupları arasında anlamlı bir farklılık bulunmadı (p>0,05). Postürografi DOT verileri açısından kontrol ve hasta grupları arasında SOMES_ML, VISUAL_ML, VES_ML, PREF_ML ve GLOBAL_ML grupları açısından anlamlı farklılık belirlendi (p<0,05). Hava yolu kemik yolu aralığı verileri açısından kontrol ve hasta grupları arasında anlamlı bir farklılık belirlendi (p<0,05). Tüm gruplarda hasta grubunun hava yolu kemik yolu aralık değerleri daha yüksekti. Hasta grubunda, BEE emosyonel alt skor ve toplam skor ile hastalık süreleri arasında anlamlı farklılık bulundu(p<0,05). Hasta grubu postürografi VISUAL_ML, PREF_ML ve GLOBAL_ML değerleri ile hastalık süreleri arasında anlamlı farklılık bulundu (p<0,05). Hasta grubu vHIT değerlerinden vHIT_RL; vHIT_LL ve vHIT_LP değerleri ile her iki kulak timpanik membran perforasyon lokalizasyonları arasında anlamlı farklılık bulundu(p<0,05).Hasta grubu postürografi DOT verilerinden sadece VISUAL_ML değerleri ile her iki kulak timpanik membran perforasyonu lokalizasyonları arasında anlamlı farklılık belirlendi. Postürografi DOT verileri ile BEE toplam skor ve alt skorları arasında VİSUAL_AP boyutu ile fonksiyonel alt skoru ve BEE toplam skor arasında negatif yönde anlamlı bir ilişki bulundu. VİSUAL _ML, PREF_AP, PREF_ML, GLOBAL_AP, GLOBAL _ML skorları ile BEE toplam skor ve emosyonel, fonksiyonel ve fiziksellik alt skorları arasında negatif yönde anlamlı bir ilişki belirlendi.
Sonuç: Sonuç olarak kronik otitis media hastalarında postüral stabilitenin ve VORun hasta kulak tarafında anlamlı derecede etkilendiği tesbit edildi. Hastalık süresinin, timpanik membran perforasyon lokalizasyonu vestibüler bulguları olumsuz yönde artırdığı, timpanik membran perforasyon boyutu ve kulak akıntısının vestibüler bulgulara etkisinin olmadığı görüldü. Çalışmanın daha büyük örneklemler ile desteklenmesine ihtiyaç vardır.
Purpose: This study aimed to assess the impact of chronic suppurative otitis media (CSOM) on vestibular function using Video Head Impulse Test (vHIT) and posturography. Materials and Methods: The research was conducted on patients with CSOM attending the Ear, Nose, and Throat clinic between April 2023 and December 2023. The sample consisted of patients with CSOM aged between 18 and 65 years. A total of 51 voluntary participants diagnosed with CSOM at the ENT Department of the Faculty of Medicine, Necmettin Erbakan University, were selected as the study group. A control group comprising 40 voluntary participants with normal hearing and balance was established. After conducting ear, nose, and throat examinations for each participant, pure-tone audiometry was performed to evaluate air and bone conduction thresholds. The assessment of the vestibular system was conducted using Video Head Impulse Test (vHIT) and Posturography. Demographic information, such as age, gender, education level, medical history, and medications used, was recorded for each participant before the vestibular tests. The Dizziness Handicap Inventory (DHI) was administered to all participants. Results: Of the participants in the study group, 34 (66.7%) were female and 17 (33.3%) were male, whereas in the control group, 25 (64.3%) were female and 15 (35.7%) were male. There was no significant difference between the control and patient groups in terms of vHIT VOR gain values (p > 0.05). Significant differences were observed between the control and patient groups in posturography DOT data for SOMES_ML, VISUAL_ML, VES_ML, PREF_ML, and GLOBAL_ML groups (p < 0.05). Significant differences were also found between the control and patient groups in air-bone gap data (p < 0.05), with higher air-bone gap values observed in the patient group across all groups. In the patient group, significant differences were found between BEE emotional subscore, total score, and duration of the disease (p < 0.05). Significant differences were also observed in the patient group between posturography VISUAL_ML, PREF_ML, and GLOBAL_ML values and the duration of the disease (p < 0.05). Regarding vHIT values in the patient group, significant differences were found between vHIT_RL, vHIT_LL, and vHIT_LP values and the localization of tympanic membrane perforations in both ears (p < 0.05). Significant differences were observed only between posturography DOT VISUAL_ML values and the localization of tympanic membrane perforations in both ears. Negative significant correlations were found between Visual_AP dimension of Posturography DOT data and both functional subscore and total score of DHI. Additionally, significant negative correlations were identified between Visual_ML, Pref_AP, Pref_ML, Global_AP, and Global_ML scores of posturography and total score as well as emotional, functional, and physical subscores of DHI. Conclusion: In conclusion, this study found that postural stability and VOR were significantly affected in the affected ear of patients with chronic otitis media. The duration of the disease was found to intensify vestibular findings, whereas the size of tympanic membrane perforation and ear discharge had no effect on vestibular findings. Further studies with larger sample sizes are required to support these findings.
Purpose: This study aimed to assess the impact of chronic suppurative otitis media (CSOM) on vestibular function using Video Head Impulse Test (vHIT) and posturography. Materials and Methods: The research was conducted on patients with CSOM attending the Ear, Nose, and Throat clinic between April 2023 and December 2023. The sample consisted of patients with CSOM aged between 18 and 65 years. A total of 51 voluntary participants diagnosed with CSOM at the ENT Department of the Faculty of Medicine, Necmettin Erbakan University, were selected as the study group. A control group comprising 40 voluntary participants with normal hearing and balance was established. After conducting ear, nose, and throat examinations for each participant, pure-tone audiometry was performed to evaluate air and bone conduction thresholds. The assessment of the vestibular system was conducted using Video Head Impulse Test (vHIT) and Posturography. Demographic information, such as age, gender, education level, medical history, and medications used, was recorded for each participant before the vestibular tests. The Dizziness Handicap Inventory (DHI) was administered to all participants. Results: Of the participants in the study group, 34 (66.7%) were female and 17 (33.3%) were male, whereas in the control group, 25 (64.3%) were female and 15 (35.7%) were male. There was no significant difference between the control and patient groups in terms of vHIT VOR gain values (p > 0.05). Significant differences were observed between the control and patient groups in posturography DOT data for SOMES_ML, VISUAL_ML, VES_ML, PREF_ML, and GLOBAL_ML groups (p < 0.05). Significant differences were also found between the control and patient groups in air-bone gap data (p < 0.05), with higher air-bone gap values observed in the patient group across all groups. In the patient group, significant differences were found between BEE emotional subscore, total score, and duration of the disease (p < 0.05). Significant differences were also observed in the patient group between posturography VISUAL_ML, PREF_ML, and GLOBAL_ML values and the duration of the disease (p < 0.05). Regarding vHIT values in the patient group, significant differences were found between vHIT_RL, vHIT_LL, and vHIT_LP values and the localization of tympanic membrane perforations in both ears (p < 0.05). Significant differences were observed only between posturography DOT VISUAL_ML values and the localization of tympanic membrane perforations in both ears. Negative significant correlations were found between Visual_AP dimension of Posturography DOT data and both functional subscore and total score of DHI. Additionally, significant negative correlations were identified between Visual_ML, Pref_AP, Pref_ML, Global_AP, and Global_ML scores of posturography and total score as well as emotional, functional, and physical subscores of DHI. Conclusion: In conclusion, this study found that postural stability and VOR were significantly affected in the affected ear of patients with chronic otitis media. The duration of the disease was found to intensify vestibular findings, whereas the size of tympanic membrane perforation and ear discharge had no effect on vestibular findings. Further studies with larger sample sizes are required to support these findings.
Açıklama
Anahtar Kelimeler
Kronik süpüratif otitis media, postüral stabilite, vestibulooküler refleks, postürografi, Video Head Impulse Test, Chronic suppurative otitis media, postural stability, vestibulo-ocular reflex, posturography
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Scopus Q Değeri
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Künye
Salahova, N. (2024). Kronik Süpüratif Otitis Medialı Erişkinlerde Postüral Stabilite Ve Vestibülooküler Refleksin Değerlendirilmesi. (Yayınlanmamış tıpta uzmanlık tezi) Necmettin Erbakan Üniversitesi, Tıp Fakültesi Cerrahi Tıp Bilimleri Bölümü Kulak Burun Boğaz Anabilim Dalı, Konya.
