VIDEO HEAD IMPULSE AND SUPPRESSION HEAD IMPULSE TEST IN CHRONIC OTITIS MEDIA PATIENTS ALI YILDIRIM1*, Nebi M. Gumus2, Ece D. Duman1, ilayda Kiran1

Abstract

Word count: 210 Background: Chronic otitis media (COM) may silently compromise vestibular function before patients develop overt imbalance. Detecting such subclinical changes is clinically relevant but remains challenging. Objective: This study aimed to determine whether adults with COM exhibit measurable abnormalities of lateral semicircular-canal function when assessed with both the video head-impulse test (vHIT) and the suppression head-impulse paradigm (SHIMP), and to examine whether vestibular metrics relate to hearing status. Methods: We conducted a cross-sectional case–control study of 20 adults with COM (25–55 years) and 20 age-matched healthy controls. All participants underwent pure-tone audiometry, vHIT, and SHIMP testing. Results: Pure-tone thresholds were significantly higher in the COM group across 0.25–8 kHz (p < 0.001). vHIT revealed comparable lateral-canal gains between groups (COM: 0.86 ± 0.06 left, 0.89 ± 0.06 right; controls: 0.88 ± 0.05, 0.90 ± 0.04; both p > 0.05), with no covert or overt refixation saccades. SHIMP, in contrast, demonstrated clear abnormalities: COM ears showed higher canal gains (left p = 0.001; right p = 0.007) and significantly smaller overt saccade amplitudes (left p = 0.001; right p = 0.004). Conclusion: The discordance between normal vHIT and abnormal SHIMP results suggests central compensation for subtle peripheral dysfunction in COM. SHIMP therefore provides complementary sensitivity to hidden vestibular abnormalities. Despite the modest, single-center sample size, these findings support incorporating SHIMP into COM assessment to enable earlier detection and guide vestibular rehabilitation.