Immediate postoperative nystagmus and vestibular symptoms after stapes surgery.

Acta oto-laryngologica

PubMedID: 23597180

Hirvonen TP, Aalto H. Immediate postoperative nystagmus and vestibular symptoms after stapes surgery. Acta Otolaryngol. 2013;133(8):842-5.
CONCLUSION
Vestibular disturbance is frequent, but mild even immediately after stapes surgery. Vestibular symptoms improved or disappeared quickly, and they did not correlate with nystagmus. Outpatient stapes surgery performed under local anaesthesia is a feasible approach.

OBJECTIVE
Vestibular symptoms are common and may prevent outpatient surgery. The time course of vestibular disturbance is unclear, and we aimed to evaluate it immediately after the operation in the recovery room.

METHODS
Twenty patients with otosclerosis undergoing stapedotomy were prospectively included in the study. Postoperative symptoms were collected and nystagmus was recorded with video-oculography (VOG) on average 29 min after the surgery.

RESULTS
None of the patients had spontaneous nystagmus with gaze fixation. Nine patients (45%) had slow spontaneous horizontal nystagmus (mean slow phase velocity of 1.1°/s) in the primary position without gaze fixation. In seven of these, the nystagmus obeyed Alexander's law. Nine patients (45%) had vestibular symptoms at the end of the surgery, and four patients at the time of VOG recording. Vertigo was experienced immediately after the operation in five, floating sensation in two, and unspecific dizziness in two patients. Vestibular symptoms were mild or moderate in most patients. The occurrence of nystagmus did not correlate with vestibular symptoms (p > 0.05).