gms | German Medical Science

Introduction: The study of vestibular disorders in patients with concomitant inflammatory and vascular effects on the vestibular analyzer is determined by their considerable frequency. First of all, there are difficulties in identifying the causes of vestibular disorders in chronic suppurative otitis media, been accompanied by a pathology of the cardiovascular system. Vestibular nystagmus is the most important symptom which confirms patients’ complaints of dizziness.

Methods: Otoneurological examination, including positional test, was perfomed in 125 patients who were divided into three groups:

1.

38 patients with chronic suppurative otitis media epitympanalis (CSOM);

2.

30 patients with vertebrobasilar insufficiency (VBI);

3.

The 57 individuals with a combination of chronic suppurative otitis media and vertebrobasilar insufficiency (CSOM + VBI).

Positional nystagmus was investigated by the methods proposed by Pr. G.M. Grigoriev.

Results: A positional nystagmus in patients with VBI was 5 times more frequently observed than spontaneous.

In patients with a combination of CSOM and VBI a positional nystagmus was detected four times more frequently than spontaneous, respectively (47:11). Noteworthy is the fact that by patients in the first group the true positional nystagmus was much more frequently observed (P <0,01), than cervical positional nystagmus and positioning nystagmus. In general, in the third and fourth groups of patients all the types of positional nystagmus were 4-5 times more often detected than spontaneous nystagmus, which is characteristic of dizziness of vascular origin.

Conclusions: These results are important for differential diagnosis of vertigo in patients with a combination of CSOM and VBI.

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