Video-oculography findings in patients with otosclerosis.
OBJECTIVE
To evaluate the existence of vestibular irritation with video-oculography before and after stapes surgery and to examine whether there would be signs of specific end-organ irritation.


METHODS
A prospective study of preoperative and postoperative nystagmus, vertigo, and hearing thresholds.


METHODS
University hospital, tertiary referral center.


METHODS
Thirty-three patients (mean age, 47 yr) with otosclerosis.


METHODS
Stapedotomy/stapedectomy with laser or microdrill.


METHODS
Spontaneous, gaze-evoked, and head-shaking nystagmus was measured preoperatively and approximately 1 week, 1 month, and 3 months after the operation. Three dimensions of nystagmus were identified and their slow-phase velocities were calculated.


RESULTS
Spontaneous horizontal nystagmus was found preoperatively in 18% (slow-phase velocities, 1.3-3.3 deg/s) and postoperatively in 11 to 19% of the patients (slow-phase velocities, 1.3-3.8 deg/s). Head-shaking nystagmus was not detected preoperatively. After the operation, 11 to 15% of the patients had head-shaking nystagmus (slow-phase velocities, 6.6-17.8 deg/s), but this prevalence did not differ statistically significantly from the preoperative level (p = 0.18). Vertical nystagmus was found equally pre- and postoperatively. Torsional nystagmus was not found. One week after the operation, nine patients (27%) had some sensation of vertigo, but it lasted over 1 month in only one patient. We found no significant correlation with vertigo and the types of nystagmus.


CONCLUSIONS
Nystagmus with a low slow-phase velocity can occur in patients with otosclerosis. However, according to the video-oculographic findings and subjective symptoms, significant vestibular dysfunction seems to be rare and temporary after stapes surgery.
Kujala
Juuso
J
Department of Otorhinolaryngology, Helsinki University Central Hospital, Helsinki, Finland. juuso.kujala@kymshp.fi
Aalto
Heikki
H
Hirvonen
Timo P
TP
D000328:Adult; D000368:Aged; D001301:Audiometry, Pure-Tone; D001309:Auditory Threshold / Q000502:physiology; D001844:Bone Conduction / Q000502:physiology; D004584:Electronystagmography / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008575:Meniere Disease / Q000175:diagnosis; D008875:Middle Aged; D009759:Nystagmus, Pathologic / Q000175:diagnosis*; D010040:Otosclerosis / Q000601:surgery*; D011183:Postoperative Complications / Q000175:diagnosis*; D013201:Stapes Surgery; D014741:Video Recording