만성중이염 환자와 정상성인에서 공기 온도안진검사의 신뢰성

Abstract

Background and Objectives: To investigate reliability of the air caloric testcompared to the water caloric test and to determine whether anatomical alterationsdue to chronic otitis media (COM) influence air caloric response. Materials andMethods: Fifty-six subjects without vestibulopathy (24 healthy individuals ascontrol group and 32 patients with unilateral COM as experimental group) wereincluded. The bithermal water and air caloric test were sequentially conductedin control group. The bithermal air caloric tests, high-resolution temporal bonecomputed tomography and endoscopic photography of the ear drum were obtainedfrom experimental group. Results: Although maximal slow phase velocities andtime to reach peak velocity using water irrigation were significantly higher andshorter, respectively, than those by air irrigation in normal subjects, caloricparameters on air caloric test agreed well with those of water caloric testing.However, inverted nystagmus occurred in 16 ears of 16 subjects, which waspredominantly presented during warm air stimulation in the com patient group.The large tympanic membrane perforation and asymmetrical mastoidpneumatization were significant parameters affecting caloric response. Thepresented prediction model for cold-induced mspvs corresponded with observedvalues according to mastoid pneumatization. Conclusion: Although the aircaloric stimuli resulted in a reliable response in healthy subjects, air caloricresults among com patients affected by anatomical alteration as well as irrigationtemperature. Presented mathematical model for cold induced mspv could serveas a good reference in measuring true vestibular function in com patients.