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Postmastoidectomy Hyperacusis Syndrome: Clinical Features and Treatment
Summary
A novel postmastoidectomy hyperacusis syndrome (PMHS) can occur after mastoid surgery. Surgical resurfacing of the mastoid cortex with hydroxyapatite bone cement effectively resolves this disabling touch-induced hyperacusis.
Area of Science:
- Otolaryngology
- Neurosurgery
- Audiology
Background:
- A novel syndrome, postmastoidectomy hyperacusis syndrome (PMHS), is described in patients experiencing hyperacusis to touch stimuli.
- This condition specifically affects patients post-cortical mastoidectomy, presenting with hypersensitivity to pinna and periauricular area touch.
Purpose of the Study:
- To characterize the clinical presentation of PMHS.
- To evaluate the efficacy of mastoid cortex resurfacing with hydroxyapatite bone cement for treating PMHS.
Main Methods:
- Case series of three patients with PMHS following intact canal wall mastoidectomies.
- Surgical intervention involved mastoid cortex resurfacing using hydroxyapatite bone cement.
- Postoperative assessment included evaluating touch-induced hyperacusis and audiometry, along with examination for synchronous tympanic membrane movement.
Main Results:
- All patients experienced complete resolution of touch-induced hyperacusis after surgery.
- Audiometric hearing thresholds remained stable post-intervention.
- Synchronous tympanic membrane movement with postauricular palpation resolved post-surgery.
Conclusions:
- PMHS is a distinct complication of cortical mastoidectomy, even without prior ear disease.
- Early recognition, particularly by examining for synchronous tympanic membrane movement, is crucial.
- Mastoid cortex resurfacing with hydroxyapatite bone cement offers a safe and effective treatment for PMHS.
