DIAGNOSIS IN THE PRESENCE OF PERSISTENT V ERTIGO FOLLOWING STAPES SURGERY

One hundred sixty-hive otosclerotic patients who underwent a stapedoto my between October 1991 and April 1994 were examined after experiencin g postoperative vertigo. Twenty-eight complained of dizziness. In sixt een patients, we observed vertigo and nystagmus only within the first six postoperative days; in these cases, special treatment was not nece ssary. However, in twelve patients in whom vertigo persisted even afte r their stay in the hospital, the problem seriously affected their qua lity of life and their return to work. In these cases, an individualiz ed diagnostic and therapeutic procedure was indicated. Case reports de monstrate the usefulness of several diagnostic methods (analysis of th e case history, audiogram, investigation of the vestibular system, and elimination of non-vestibular causes of vertigo. But only high-resolu tion computed tomography scans of the temporal bone showed definite re sults. Air bubbles at the end of the prothesis as indirect sign of per ilymphatic fistula, bad position of the piston, new centers of otoscle rosis, cicatrices, and in one case fracture of the prothesis. Ten of t he twelve patients required revision surgery. In most patients with pe rsisting vertigo following stapedotomy, revision surgery was justified . However, high-resolution computed tomography is recommended.