Lozova Y. Investigation of Vestibular Function in Children with Acute Otitis Media Using the Static Computer Stabilometry Method

The dissertation is devoted to the improvement of differential diagnostics of vestibular disorders in children with acute otitis media for timely correction and prevention of persistent disorders of the stato-acoustic analyzer in the future. The work has been performed at the Children's Otolaryngology Department of Communal Non-Commercial Enterprise "City Clinical Hospital № 30" of Kharkiv City Council, which is the clinical base of the Otolaryngology and Children's Otolaryngology Department of Kharkiv Medical Academy of Postgraduate Education. The analysis of literary sources and archival materials on the morbidity of children with acute otitis media (AOM) who were treated in the Children's Department in 2015–2019 has been carried out. As a result, the most important age category of children for the study has been determined. The main research groups were formed with the determination of the age category of the examined children: group I (45 patients) consisted of children with non-purulent AOM; group II (45 patients) was formed of children with purulent AOM; control group (50 patients) consisted of children without AOM with normal hearing.Clinical, otoneurological, audiometric and stabilometric examinations of the patients of the specified groups have been carried out. The obtained results have been analyzed and compared between the groups, and mathematical and statistical analysis has been conducted. At the stage of summarizing the results, a discriminant analysis (mathematical modeling) was performed to predict the course of the disease depending on its form and possible negative consequences as well as complications of AOM in children in the future. The study of the prevalence and features of the clinical picture of AOM in children of different ages required inpatient treatment (according to archival data) has revealed a consistently high (19.5 %) percentage of such patients. The dominant pathologies in the case of AOM were a purulent inflammatory process (44.8 %), secretory inflammation (31 %) and viral inflammation (24.2 %). Children aged 2-5 years old (57.2 %) with AOM were most often hospitalized. Among them, there were patients with purulent otitis media (67.2 %), secretory variant of the course (65.7 %) and viral variant of the course (55.5 %). At the same time, for all groups of AOM a statistically significant difference was determined in children aged 6–10 years old. It has been found that the complications of purulent and viral AOM, apart from traditional mastoiditis and acute sensorineural deafness for children, were quite significant manifestations of CSF hypertension syndrome (16.8% and 37.2%, respectively) and intoxication syndrome (24.6% and 66%, respectively), which did not rule out the probable involvement of the vestibular analyzer. The study of auditory and vestibular functions in children of the control group has revealed that the traditional otoneurological examination of such patients does not provide a complete clinical description of the vestibular state. The method of static computer stabilometry, on the contrary, has made it possible to investigate children’svestibular system in a playful way. We have found that an averaged figure of the projection of the pressure center in the sample with closed and open eyes in children of the control group is represented by an ellipse, that indicates the dominance of the ankle-foot strategy for maintaining posture, which is physiological for maintaining balance and points to the absence of vestibular system pathology.