[Coincidence of chronic inflammatory paranasal sinus disorders and cochleo-vestibular disorders]

In the course of initial examination the authors frequently observed a coincidence of labyrinthine symptoms with radiologic signs of chronic sinusitis. Of 72 patients who were hospitalized for acute labyrinthine symptoms, 72% presented with these signs. On the other hand, 49% of the patients admitted to sinus surgery manifested labyrinthine symptoms. A well-pneumatized mastoid was found in both groups. In the control group, consisting of patients whose consultation was unconnected to ear or nose complaints, chronic sinusitis was found in 28% and labyrinthine symptoms in 24%, but the two together were only found in 11%. It was shown by means of the chi2 test that the two symptom complexes are interdependent (p less than 0.01). Histologic examination of the mucosa of paranasal sinuses and peri-labyrinthine cells does not at the moment provide a satisfactory explanation. Pathologic autonomic nerve connections between the two systems may lead to higher vulnerability of the labyrinths of patients with chronic sinusitis. Other possible explanations, i.e., relating to certain neuropeptides and a well-pneumatized mastoid, are discussed. The authors wish to emphasize that their study is based on clinical data. At the moment a satisfactory pathophysiological explanation is lacking. In addition to antiphlogistic and rheologic medication, long-term planning of sinus surgery should be recommended for all patients in whom the two symptoms occur simultaneously. Whether this can help prevent recurrences, or put an end to progressive processes, can only be determined after a longer observation period.