Job Katarzyna, Wiatr Agnieszka, Wiatr Maciej
Department of Otolaryngology, Jagiellonian University Medical College in Kraków, Poland.
Ear Nose Throat J. 2023 Nov;102(11):709-714. doi: 10.1177/01455613211023014. Epub 2021 Jun 28.
During the postoperative period, most patients with otosclerosis report vertigo and/or nausea caused by interventions within the inner ear. The aim of this study was to evaluate both early and late vertigo associated with hearing improvement after stapes surgery for otosclerosis.
The analysis included 170 patients admitted to the hospital undergoing their first surgery for otosclerosis. Audiological diagnostics, surgical techniques, and symptoms reported by the patients were all analyzed.
A statistical correlation and an unfavorable influence of late, undesired symptoms, such as vertigo, nausea/vomiting, and nystagmus, on final hearing improvement after surgical treatment of otosclerosis were found. Prostheses that were too long or placed too deep within the inner ear space were the most frequent cause of both vertigo and lack of hearing improvement observed after stapedotomy.
A significant negative influence on bone conduction thresholds, particularly at 2000 Hz, was associated with vestibular symptoms persisting for 7 days after the surgery. Symptoms of impaired bony labyrinth function after stapedotomy, persisting for more than 1 year, were associated with insufficient reduction of the air-bone gap and worse improvement in bone conduction thresholds at 1000 and 2000 Hz. The cause of both problems was related to a prosthesis that was too long or placed too deep in the inner ear during stapedotomy.
在术后期间，大多数耳硬化症患者报告有因内耳干预导致的眩晕和/或恶心。本研究的目的是评估耳硬化症镫骨手术后与听力改善相关的早期和晚期眩晕。
分析纳入了170例因耳硬化症首次入院接受手术的患者。对听力学诊断、手术技术以及患者报告的症状进行了全面分析。
发现耳硬化症手术治疗后，晚期不良症状，如眩晕、恶心/呕吐和眼球震颤，与最终听力改善之间存在统计学相关性和不利影响。镫骨足板开窗术后观察到的眩晕和听力改善不佳的最常见原因是假体过长或在内耳空间放置过深。
术后持续7天的前庭症状与骨导阈值，尤其是2000Hz处的骨导阈值显著下降有关。镫骨足板开窗术后骨迷路功能受损症状持续超过1年，与气骨导间距缩小不足以及1000Hz和2000Hz处骨导阈值改善较差有关。这两个问题的原因都与镫骨足板开窗术中假体过长或在内耳放置过深有关。
