117 Middle ear effusion has been considered the most common cause of vestibular disturbance in chil- dren. However, there have been only a few studies on vestibular disturbance in children with otitis media with effusion. We studied the vestibular sys- tems of 30 children with otitis media with effusion aged 8 to 13 years and compared the results with 15 age- and sex-matched controls. A question- naire relating to vestibular disturbance was given to patients and their parents. Spontaneous nystag- mus and positional nystagmus were recorded by electronystagmography as diagnostic tests of the vestibular system. Romberg’s and past-pointing tests were performed on children with otitis media with effusion and controls. After vestibular tests were completed, myringotomy was performed, and a ventilation tube was inserted. The question- naire and the vestibular tests were repeated after the operation and during the first month after surgery. Our study showed that there was a history of vestibular disturbance in 33% of children with oti- tis media with effusion. Electronystagmography and Romberg’s test findings demonstrated that 33% of the children had vestibular dysfunction (p < 0.05). After myringotomy with ventilation tube inser- tion, vestibular test results returned to normal, and symptoms related to vestibular disturbance improved. These findings confirm the assumption that middle ear effusion may affect the vestibular system, which can be resolved after myringotomy with ventilation tube insertion. (Otolaryngol Head Neck Surg 1999;120:117-21.) Otitis media with effusion (OME) is one of the most common chronic otologic diseases of childhood after upper respiratory tract infections. 1 It was first men- tioned in 1977 that OME can cause balance disorders, and it has been considered the most common cause of vestibular disturbances and vertigo in children for the past 10 years. 2 However, the incidence of vestibular disorders in children with OME, the effect of effusion in the middle ear on the vestibular system, and the role of myringotomy with ventilation tube insertion on the relief of vestibular disorders have not been clearly established. The aim of this study was to investigate whether there was any disturbance in the vestibular system between a group with OME and an age- and sex- matched control group and whether myringotomy and insertion of ventilation tubes affected this crite- rion. Vestibular tests such as spontaneous nystagmus and positional nystagmus by electronystagmography (ENG), Romberg, and past-pointing tests were per- formed on the children with OME and on a control group. After treatment of OME by myringotomy with ventilation tube insertion, these tests were repeated. In addition, the results of Romberg and past-pointing tests, which are performed easily at the clinic, were compared with the results of nystagmus by ENG. METHODS AND MATERIAL The study was performed on 30 children with OME aged 8 to 13 years (17 males and 13 females; average age, 10.6 ± 2 years). Fifteen age- and sex-matched normal children attending an ear, nose, and throat clinic were assessed as con- trols. The children were evaluated by otologic examination and tympanometry. All children were given three periods of consecutive medical treatment including antibiotics, antihist- amines, and nasal decongestants. Systemic and otorhino- laryngologic examinations were made, and the diseases affecting the central nervous system, such as low birth weight, neonatal asphyxia, ear malformations, sensorineural INTERNATIONAL ORIGINAL ARTICLES EUGENE N. MYERS, MD International Editor Effects of otitis media with effusion on the vestibular system in children MEHMET KOYUNCU, M. MUH ˙ ITT ˙ IN SAKA, YÜCEL TANYER ˙ I, TEOMAN S 5 ES 5 EN, RECEP ÜNAL, AT ˙ ILLA TEKAT, and FAT ˙ IH YILMAZ, Samsun, Turkey From the Department of Otolaryngology, University Hospital, Ondokuz Mayis University Medical School. Reprint requests: M. Koyuncu, Department of Otolaryngology, University Hospital, Ondokuz Mayis University Medical School, 55139 Samsun, Turkey. Copyright © 1999 by the American Academy of Otolaryngology– Head and Neck Surgery Foundation, Inc. 0194-5998/99/$8.00 + 0 23/77/84683