Examination of risk factors for postoperative vestibular symptoms in patients with cholesteatoma

Abstract

Background

In cholesteatoma, the prognosis of tympanoplasty has been well discussed in terms of hearing outcomes and residual or recurrent lesions. Postoperative dizziness and vertigo are major complications of tympanoplasty; however, few reports are available.

Aims/Objectives

We investigated each condition of cholesteatoma postoperative vestibular risk using the STAM system and staging published by EAONO/JOS, as well as findings on bony destruction.

Material and methods

From April 2010 to March 2021, 156 patients (166 ears) with cholesteatoma who underwent primary microscopic tympanoplasty at our hospital were registered. Subjective vestibular symptoms were recorded the day after surgery.

Results

Postoperative vestibular symptoms were observed in 13.9% of subjects. All of them were stage II and had both attic and mastoid lesions. Attic (p < .05) and mastoid (p < .01) lesions were risk factors. Multivariate analysis showed that significant differences were found in past histories of vestibular symptoms (p < .05) and exposure of the dura mater (p < .01).

Conclusions and Significance

In the exposed dura group, the length of the prominence of the lateral semicircular canal to the middle cranial fossa dura was significantly shorter than that of the non-exposed group (p < .01). Narrow working space and downward operation may increase vestibular risk.

Chinese Abstract

背景：对于胆脂瘤, 鼓室成形术的预后已经在听力结果和残留或复发性病变方面得到了充分的讨论。术后头晕眩晕是鼓室成形术的主要并发症；然而, 关于此的报告很少。

目的：我们使用EAONO/JOS 发布的 STAM 系统和分期, 以及关于骨损坏的资料, 调查了胆脂瘤术后前庭风险的每种情况。

材料与方法： 2010年4月至2021年3月, 我们登记了156例（166耳）在我院接受过一次显微鼓室成形术的胆脂瘤患者。在术后第二天记录了他们的主观前庭症状。

结果：在 13.9% 的受试者中观察到术后前庭症状。他们都是II期, 有顶部和乳突病变。顶部 (p < .05) 和乳突 (p < .01) 病变是风险因素。多变量分析表明, 前庭症状 (p < .05) 和硬脑膜暴露 (p < .01) 的既往史存在显著差异。

结论和意义：硬脑膜暴露组外侧半规管突出至中颅窝硬脑膜的长度明显短于非暴露组（p < .01）。狭窄的操作空间和向下手术可能会增加前庭风险。

Keywords:

• Cholesteatoma
• tympanoplasty
• postoperative vestibular symptoms

Disclosure statement

No potential competing interest was reported by the authors.