Page 41 - Portuguese Journal - SPORL - Vol 61. Nº2

demonstrated by the caloric test and vHIT that the exams were performed by more
results (in which the gains were significantly
lower in the otosclerosis group than in the
control group). To the best of our knowledge,
no study thus far has performed a subjective
assessment of the quality of life related
to vestibular symptoms in patients with
otosclerosis by comparing them to healthy
individuals. In this study, no significant
difference was found in the results of the vHIT
between the otosclerosis group (unilateral
and bilateral disease) and control group—
in the gains calculated for the VOR of the
semicircular canals and the presence of
corrective saccades (Table 2).
Moreover, there was a statistically significant
difference in the total score obtained in the DHI
questionnaire and the partial scores obtained
in its three domains (physical, functional, and
emotional) between the two study groups
(Table 3).
Thus, the data suggest a relationship between
otosclerosis and a higher prevalence of
vestibular symptoms, which does not appear
to be explained by the results of the vHIT.
These findings are in line with the results of
Catalano et al. , who reported that there was
4
no effect of otosclerosis on the function of the
semicircular canals, as measured by the vHIT.
However, these findings diverge from those of
two more recent studies on the topic , which
5,6
reported the involvement of this system.
The main limitation of this study was the
small sample size, which led to a reduction in
the capacity to measure effects. Further, the
analysis was performed on individuals rather
than the affected ears, and this may have
affected the statistical analysis—the inclusion
of healthy ears in the unilateral otosclerosis
group. The determining factor for this
limitation was the fact that the device used in
the study (ICS Impulse System, GN Otometrics)
is a system of monocular acquisition that
tends to overestimate the gains on the side
where the camera is positioned (right side).
The use of a system with binocular acquisition
would circumvent this limitation.
A limitation regarding the vHIT was the fact
than one operator, with potential technical
bias. Another important limitation, which
is common to all studies in which answers
to questionnaires are evaluated, was the
high subjectivity of their interpretation and
potential exceptional uncontrollable factors
that may influence the responses at the time
of completing the questionnaire.
In the future, this issue should be addressed
by using larger samples and conducting
comprehensive studies on all components
of vestibular function to obtain an overall
assessment of these patients. Comparative
pre- and postoperative evaluations should
also be performed to understand the impact
of stapedotomy on vestibular function and
determine the presence of modifying factors.
Conclusions
In this study, subjective functional
impairment of balance was observed in
patients with otosclerosis (as was shown in
the DHI questionnaire) who did not appear
to be associated with a dysfunction of the
semicircular canals, as shown by the vHIT.
Further studies should be conducted with
larger samples to evaluate this issue and assess
the remaining components of vestibular
function in patients with otosclerosis—
through VEMPs and caloric tests.
Conflicts of Interest
The authors declare that there is no conflict
of interests regarding the publication of this
paper.
Data Confidentiality
The authors declare having followed the
protocols in use at their working center
regarding patients’ data publication.
Protection of humans and animals
The authors declare that the procedures
were followed according to the regulations
established by the Clinical Research and Ethics
Committee and to the 2013 Helsinki Declaration
of the World Medical Association.
Volume 61 . Nº2 . June 2023 183