Comprehensive Evaluation of Post-Operative Balance Function Following Mastoidectomy in Patients with Chronic Otitis Media
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Abstract
Background and Aim: Patients with chronic otitis media (COM) who undergo mastoidectomy sometimes experience imbalance, dizziness, and vertigo after the surgery. This study aimed to investigate the effects of mastoidectomy on the balance of patients with COM using standard and advanced balance tests.
Methods: The study was conducted in 2024 in Imam Reza and Ghaem hospitals affiliated with Mashhad University of Medical Sciences, Mashhad, Iran. Forty patients scheduled for mastoidectomy were enrolled over a 12-month period using a census method. Patients underwent balance tests before and after surgery. These tests included the Video Head Impulse Test (vHIT), Subjective Visual Vertical (SVV), and Posturography.
Results: Statistical analysis of the performance parameter under linear or sinusoidal plate movement conditions showed no significant difference before and after the surgery (P > 0.05). Statistical analysis of the Gain in the six semicircular canals in the vHIT test also showed no significant difference before and after the surgery (P > 0.05). Similarly, statistical analysis of the deviation from the norm in the neutral position, -30° head tilt to the right, and -30° head tilt to the left showed no significant difference before and after the surgery (P > 0.05).
Conclusion: The results of this study showed that mastoidectomy does not have a significant effect on balance tests, so performing it may not lead to severe balance disorders in patients with chronic otitis media who are candidates for mastoidectomy surgery.
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12. Klemens JJ, Mhoon E, Redleaf M. Is simultaneous bilateral mastoidectomy ever advisable? J Laryngol Otol. 2007;121(11):1041-7. [DOI:10.1017/S0022215107006330]
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14. Kang WS, Lee SH, Yang CJ, Ahn JH, Chung JW, Park HJ. Vestibular Function Tests for Vestibular Migraine: Clinical Implication of Video Head Impulse and Caloric Tests. Front Neurol. 2016;7:166. [DOI:10.3389/fneur.2016.00166]
15. Manzari L, Princi AA, De Angelis S, Tramontano M. Clinical value of the video head impulse test in patients with vestibular neuritis: a systematic review. Eur Arch Otorhinolaryngol. 2021;278(11):4155-67. [DOI:10.1007/s00405-021-06803-8]
16. Bae S, Yun J, Kwak S, Jung H, Lee H, Kim J, et al. High-Frequency Vestibular Function Is Vulnerable to Presbyvestibulopathy. Diagnostics (Basel). 2024;14(12):1224. [DOI:10.3390/diagnostics14121224]
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18. Miłoński J, Pietkiewicz P, Bielińska M, Kuśmierczyk K, Olszewski J. The use of videonystagmography head impulse test (VHIT) in the diagnostics of semicircular canal injuries in patients with vertigo. Int J Occup Med Environ Health. 2014;27(4):583-90. [DOI: 10.2478/s13382-014-0278-4]
19. Mansour S, Magnan J, Nicolas K, Haidar H, Mansour S, Magnan J, et al. Chronic suppurative otitis media (CSOM): a middle ear mucosal disease. Middle Ear Diseases: Advances in Diagnosis and Management. 2018:205-74.
20. Merkus P, Kemp P, Ziylan F, Yung M. Classifications of Mastoid and Middle Ear Surgery: A Scoping Review. J Int Adv Otol. 2018;14(2):227-232. [DOI:10.5152/iao.2018.5570]
21. Yorgancılar E, Yildirim M, Gun R, Bakir S, Tekin R, Gocmez C, et al. Complications of chronic suppurative otitis media: a retros pective review. Eur Arch Otorhinolaryngol. 2013;270(1):69-76. [DOI:10.1007/s00405-012-1924-8]
22. Khalil HS, Windle-Taylor PC. Canal wall down mastoidectomy: A long-term commitment to the outpatients? BMC Ear Nose Throat Disord. 2003;3(1):1. [DOI:10.1186/1472-6815-3-1]
23. Zakaria MN, Salim R, Tahir A, Zainun Z, Mohd Sakeri NS. The influences of age, gender and geometric pattern of visual image on the verticality perception: A subjective visual vertical (SVV) study among Malaysian adults. Clin Otolaryngol. 2019;44(2):166-71. [DOI:10.1111/coa.13255]
24. Tesio L, Longo S, Rota V. The subjective visual vertical: validation of a simple test. Int J Rehabil Res. 2011;34(4):307-15. [DOI:10.1097/MRR.0b013e32834c45bc]
25. Rezvani Amin M, Behzad H. The impact examination of the head tilt size on the subjective visual vertical (SVV) among the normal individuals with ages ranged from 18 to 35 years. Hearing, Balance and Communication. 2022;20(2):129-34. [DOI:10.1080/21695717.2022.2033947]
26. Shirejini MB, Farahani A, Nazeri A. The application of subjective visual vertical in balance system disorders. Aud Vestib Res. 2018;27(1):1-11.
27. Karakuzu AT, Özel HE, Temir H, Özdoğan F, Genç S, Çalışkan S. Effect of drilling on otolithic organ functions in mastoidectomy. J Laryngol Otol. 2024;1-5. [DOI:10.1017/S0022215124000598]
28. Gupta A, Prasad BK. Assessment of balance by posturography: A comparative study in pre and post operative patients undergoing canal wall up and canal wall down mastoidectomy. J Otorhinolaryngol Disord Treat. 2018;1(1). DOI: http://dx.doi.org/10.16966/jodt.103
2. Browning GG, Weir J, Kelly G, Swan IRC. Chronic otitis media. In: Watkinson JC, Clarke RW, editors. Scott-Brown’s Otorhinolaryngology Head & Neck Surgery. 8th ed. Vol. 2. Roca Raton: CRC Press; 2018. p. 977–1020.
3. Lasisi A, Afolabi O. Mastoid surgery for chronic ear: a ten year review. Internet J Head Neck Surg. 2007;2(2):13.
4. Monsanto RDC, Kasemodel ALP, Tomaz A, Elias TGA, Paparella MM, Penido NO. Evaluation of vestibular symptoms and postural balance control in patients with chronic otitis media. J Vestib Res. 2020;30(1):35-45. [DOI:10.3233/VES-200691]
5. Wilhelm T, Stelzer T, Hagen R. Sensorineural hearing loss after otitis media with effusion and subacute mastoiditis after viral infections of the upper respiratory tract: A comparative study of conservative and surgical treatment. Ear Nose Throat J. 2016;95(9):E18-27. [DOI:10.1177/014556131609500908]
6. Pontillo V, Ciprelli S, Grillo R, Quaranta N. Quality of life after revision mastoidectomy with mastoid obliteration. Acta Otorrinolaringol Esp (Engl Ed). 2023; 74(6):352-8. [DOI:10.1016/j.otoeng.2023.06.004]
7. Young AS, Rosengren SM, Welgampola MS. Disorders of the inner-ear balance organs and their pathways. Handb Clin Neurol. 2018;159:385-401. [DOI:10.1016/B978-0-444-63916-5.00025-2]
8. Bento RF, Fonseca AC. A brief history of mastoidectomy. Int Arch Otorhinolaryngol. 2013;17(2):168-78. [DOI:10.7162/S1809-97772013000200009]
9. Mor N, Finkel DA, Hanson MB, Rosenfeld RM. Middle ear cholesteatoma treated with a mastoidectomy: a systematic review of the measures used. Otolaryngol Head Neck Surg. 2014;151(6):923-9. [DOI:10.1177/0194599814549547]
10. Dornhoffer JL, Smith J, Richter G, Boeckmann J. Impact on quality of life after mastoid obliteration. Laryngoscope. 2008;118(8):1427-32. [DOI:10.1097/MLG.0b013e318173dd7e]
11. Nadol JB Jr. Revision mastoidectomy. Otolaryngol Clin North Am. 2006;39(4):723-40, vi-vii. [DOI:10.1016/j.otc.2006.05.003]
12. Klemens JJ, Mhoon E, Redleaf M. Is simultaneous bilateral mastoidectomy ever advisable? J Laryngol Otol. 2007;121(11):1041-7. [DOI:10.1017/S0022215107006330]
13. Vincenti V, Pasanisi E, Bacciu A, Bacciu S. Long-term results of external auditory canal closure and mastoid obliteration in cochlear implantation after radical mastoidectomy: a clinical and radiological study. Eur Arch Otorhinolaryngol. 2014;271(8):2127-30. [DOI:10.1007/s00405-013-2698-3]
14. Kang WS, Lee SH, Yang CJ, Ahn JH, Chung JW, Park HJ. Vestibular Function Tests for Vestibular Migraine: Clinical Implication of Video Head Impulse and Caloric Tests. Front Neurol. 2016;7:166. [DOI:10.3389/fneur.2016.00166]
15. Manzari L, Princi AA, De Angelis S, Tramontano M. Clinical value of the video head impulse test in patients with vestibular neuritis: a systematic review. Eur Arch Otorhinolaryngol. 2021;278(11):4155-67. [DOI:10.1007/s00405-021-06803-8]
16. Bae S, Yun J, Kwak S, Jung H, Lee H, Kim J, et al. High-Frequency Vestibular Function Is Vulnerable to Presbyvestibulopathy. Diagnostics (Basel). 2024;14(12):1224. [DOI:10.3390/diagnostics14121224]
17. Taylor RL, Wise KJ, Taylor D, Chaudhary S, Thorne PR. Patterns of vestibular dysfunction in chronic traumatic brain injury. Front Neurol. 2022;13:942349. [DOI: 10.3389/fneur.2022.942349]
18. Miłoński J, Pietkiewicz P, Bielińska M, Kuśmierczyk K, Olszewski J. The use of videonystagmography head impulse test (VHIT) in the diagnostics of semicircular canal injuries in patients with vertigo. Int J Occup Med Environ Health. 2014;27(4):583-90. [DOI: 10.2478/s13382-014-0278-4]
19. Mansour S, Magnan J, Nicolas K, Haidar H, Mansour S, Magnan J, et al. Chronic suppurative otitis media (CSOM): a middle ear mucosal disease. Middle Ear Diseases: Advances in Diagnosis and Management. 2018:205-74.
20. Merkus P, Kemp P, Ziylan F, Yung M. Classifications of Mastoid and Middle Ear Surgery: A Scoping Review. J Int Adv Otol. 2018;14(2):227-232. [DOI:10.5152/iao.2018.5570]
21. Yorgancılar E, Yildirim M, Gun R, Bakir S, Tekin R, Gocmez C, et al. Complications of chronic suppurative otitis media: a retros pective review. Eur Arch Otorhinolaryngol. 2013;270(1):69-76. [DOI:10.1007/s00405-012-1924-8]
22. Khalil HS, Windle-Taylor PC. Canal wall down mastoidectomy: A long-term commitment to the outpatients? BMC Ear Nose Throat Disord. 2003;3(1):1. [DOI:10.1186/1472-6815-3-1]
23. Zakaria MN, Salim R, Tahir A, Zainun Z, Mohd Sakeri NS. The influences of age, gender and geometric pattern of visual image on the verticality perception: A subjective visual vertical (SVV) study among Malaysian adults. Clin Otolaryngol. 2019;44(2):166-71. [DOI:10.1111/coa.13255]
24. Tesio L, Longo S, Rota V. The subjective visual vertical: validation of a simple test. Int J Rehabil Res. 2011;34(4):307-15. [DOI:10.1097/MRR.0b013e32834c45bc]
25. Rezvani Amin M, Behzad H. The impact examination of the head tilt size on the subjective visual vertical (SVV) among the normal individuals with ages ranged from 18 to 35 years. Hearing, Balance and Communication. 2022;20(2):129-34. [DOI:10.1080/21695717.2022.2033947]
26. Shirejini MB, Farahani A, Nazeri A. The application of subjective visual vertical in balance system disorders. Aud Vestib Res. 2018;27(1):1-11.
27. Karakuzu AT, Özel HE, Temir H, Özdoğan F, Genç S, Çalışkan S. Effect of drilling on otolithic organ functions in mastoidectomy. J Laryngol Otol. 2024;1-5. [DOI:10.1017/S0022215124000598]
28. Gupta A, Prasad BK. Assessment of balance by posturography: A comparative study in pre and post operative patients undergoing canal wall up and canal wall down mastoidectomy. J Otorhinolaryngol Disord Treat. 2018;1(1). DOI: http://dx.doi.org/10.16966/jodt.103
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How to Cite
1.
Nourizadeh N, Fallah M, Behzad H, Kafashan S, Mehrad-Majd H. Comprehensive Evaluation of Post-Operative Balance Function Following Mastoidectomy in Patients with Chronic Otitis Media. Aud Vestib Res. 2025;.
