Inner ear impairment after stapedotomy: do the cervical vestibular evoked myogenic potentials play a diagnostic role?

Otosclerosis is characterized by a bony remodeling process that ends up with stapes fixation. The hearing impairment can be recovered by surgery by replacing the stapes superstructure. Due to the surgical management of the vestibule, the vestibular examination could provide an insight into the correlation between this kind of surgery and vestibular changes.

To evaluate the impact of the stapedotomy on the inner ear.

We evaluated pure tone audiometry and the presence of vestibular evoked myogenic potentials (VEMPs) in 41 patients with otosclerosis before and after the stapedotomy operation.

Air conduction (Ac)-VEMPs were present in 18 cases preoperatively and 31 cases postoperatively. Bone conduction (Bc)-VEMPs were present in 23 cases preoperatively and 33 cases postoperatively. ABG was closed to less than 20 dB in all cases after the operation.

The preoperative Bc-VEMPS had an outstanding capability to predict the type of hearing loss. The postoperative absence of VEMPS despite the closure of ABG indicated the impact of otosclerosis on the saccular cells. The use of Thulium Laser in stapedotomy didn't affect significantly the saccular cells.

Integrated use of audiometry and VEMPs was effective to evaluate the changes associated with otosclerosis and the stapedotomy operation.