Section: 
Science articles
Science articlesOtolitiasis in hearing improvement surgery
Zh. V. Privalova (1), D. M. Kuz’min (1), A. S. Zhorina (1)
(1) Mechnikov Northwest State Medical University Ministry of Healthcare of the Russia, Saint Petersburg, 191015, Russia
UDK: 616.287.4-089.853:616.28-008.55
DOI: https://doi.org/10.18692/1810-4800-2019-2-64-69
ABSTRACT
The objective of the study is to improve the efficacy of stapedoplasty in otosclerosis by identifying the causes of vestibular dysfunction in the postoperative period and their early correction. Results. At the period from 2015 to 2018, 95 patients diagnosed with otosclerosis were examined and operated on. All the patients underwent the following examinations to detect otolithiasis, as well as the characteristics of vestibular disorders before and after stapedoplasty: acquisition of complaints and anamnesis, standard ENT organs examination, audiological examination, otoneurological examination with video oculography, and Dix–Hallpike, Pagnini–McClure diagnostic tests. Based on the examinations in the preoperative period, otolithiasis was not detected in any of the subjects. In the postoperative period after stapedoplasty, otolithiasis was diagnosed in 20 (21%) patients. All patients with otolithiasis, as well as 23 randomly selected patients, underwent computed tomography (CT) of the temporal bones with the assessment of the depth of penetration of the prosthesis into the labyrinth atrium. As a result of the study, it was revealed that one of the causes of otolithiasis is the excessive depth of prosthesis penetration into the labyrinth atrium. In the postoperative period complicated by otolithiasis, the severity of vestibular symptoms was much higher than in patients without this complication. In the event of timely diagnosis and relief of this complication, the duration of vestibular symptoms does not significantly differ from patients without this complication. Dix–Hallpike, Pagnini–McClure positional tests can be used to diagnose otolithiasis from the 5th day of the postoperative period. The use of rehabilitation maneuvers from the 5th day of the postoperative period is an efficient method of otolithiasis management.
Publication date:
28.03.2019
Keywords:
otolithiasis, stapedoplasty, vestibular disorders, otosclerosis. For citation:
Privalova Zh. V., Kuz’min D. M., Zhorina A. S. Otolitiasis in hearing improvement surgery. Rossiiskaya otorinolaringologiya. 2019;2:64–69. https://doi.org/10.18692/1810-4800-2019-2-64-69