Inner ear impairment after stapedotomy: do the cervical vestibular evoked myogenic potentials play a diagnostic role?

Abstract

Background

Otosclerosis is characterized by a bony remodeling process that ends up with stapes fixation. The hearing impairment can be recovered by surgery by replacing the stapes superstructure. Due to the surgical management of the vestibule, the vestibular examination could provide an insight into the correlation between this kind of surgery and vestibular changes.

Objectives

To evaluate the impact of the stapedotomy on the inner ear.

Methods

We evaluated pure tone audiometry and the presence of vestibular evoked myogenic potentials (VEMPs) in 41 patients with otosclerosis before and after the stapedotomy operation.

Results

Air conduction (Ac)-VEMPs were present in 18 cases preoperatively and 31 cases postoperatively. Bone conduction (Bc)-VEMPs were present in 23 cases preoperatively and 33 cases postoperatively. ABG was closed to less than 20 dB in all cases after the operation

Conclusions

The preoperative Bc-VEMPS had an outstanding capability to predict the type of hearing loss. The postoperative absence of VEMPS despite the closure of ABG indicated the impact of otosclerosis on the saccular cells. The use of Thulium Laser in stapedotomy didn’t affect significantly the saccular cells.

Significance

Integrated use of audiometry and VEMPs was effective to evaluate the changes associated with otosclerosis and the stapedotomy operation.

Chinese Abstract

背景：耳硬化症的特点是骨重塑过程以镫骨固定终结。更换镫骨上层结构的手术可以恢复听力障碍。由于前庭的手术治疗, 通过前庭检查可以了解这种手术与前庭变化之间的相关性。

目的：评估镫骨切开术对内耳的影响。

方法：我们评估41例耳硬化症患者镫骨切开术前后的纯音测听和前庭诱发肌源性电位（VEMPs）的存在。

结果：术前18例和术后31例存在气导（Ac）-前庭诱发肌源性电位（VEMP）。骨传导（Bc）-VEMP 存在于术前 23 例和术后 33 例中。术后所有病例的 ABG 均闭合至 20 dB 以下。

结论：术前 Bc-VEMPS 具有出色的听力损失类型预测能力。尽管 ABG 闭合, 但术后 VEMPS 缺失表明耳硬化症对囊状细胞的影响。在镫骨切开术中使用铥激光对囊状细胞没有显著影响。

意义：听力测量和VEMPs的综合使用可有效评估与耳硬化症和镫骨切开术相关的变化。

Keywords:

• Stapedotomy
• saccule
• vestibular-evoked myogenic potentials
• audiometry

Disclosure statement

No potential conflict of interest was reported by the author(s).