Chronic suppurative otitis media, caloric testing, and rotational chair testing

Objective: To determine the incidence of caloric and rotational chair testing (ROT) abnormalities in a group of patients with chronic suppurative otitis media (CSOM) and to correlate caloric test results with ROT. Patients: Twenty-five patients with CSOM with or without cholesteatoma who were to undergo tympanomastoid surgery. Interventions: Caloric and ROT. Main Outcome Measures: History of dizziness. Vestibular test abnormalities defined by caloric weakness (CW), reduced gain, abnormal phase, or asymmetry on ROT. Results: Among the 25 patients, 13 had bilateral CSOM-most with long-standing disease and history of previous surgical intervention. Of the 25 patients, 19 (76%) demonstrated either unilateral or bilateral CW. Eighteen (72%) demonstrated abnormalities on ROT. Eleven patients (44%) had complaints of vertigo/dizziness, although 2 of these patients had both normal caloric testing and ROT. Unilateral or bilateral CW was 80% accurate in predicting an ROT abnormality, whereas the sympton of vertigo/dizziness was only 48% accurate in predicting an ROT abnormality. Conclusion: The incidence of CW among CSOM patients in this study was high and correlated well with abnormalities on ROT. Interestingly, ROT results correlated better with CW than symptoms of dizziness/vertigo. Although CW findings can be the result of technical limitations in testing patients with CSOM, ROT corroboration of these results suggest that they are valid findings.