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Nystagmus and Vertigo During Aural Toilet Using Microsuction
Chang-Hee Kim1, Minho Jang1, Taehee Kim1
1Department of Otorhinolaryngology-Head and Neck Surgery, Konkuk University Medical Center, Konkuk University School of Medicine, Research Institute of Medical Science, Institute of Biomedical Science & Technology, Seoul 05030, Republic of Korea.
Microsuction during ear cleaning frequently causes nystagmus and, less often, vertigo. Vertigo risk increases with specific tympanic membrane conditions like perforation, indicating a need for careful patient monitoring during aural toilet.
Area of Science:
- Otolaryngology
- Neuroscience
Background:
- Aural toilet with microsuction is a common ENT procedure.
- Vertigo is a frequent patient complaint during this procedure.
Purpose of the Study:
- To investigate the characteristics and incidence of microsuction-induced nystagmus and vertigo.
- To correlate these symptoms with tympanic membrane (TM) appearance.
Main Methods:
- Assessed microsuction-induced vertigo and nystagmus in 85 patients with diverse TM appearances.
- Recorded nystagmus direction based on patient positioning.
Main Results:
- Nystagmus occurred in 95% of patients; vertigo in 36%.
- Nystagmus direction varied with positioning (ipsilateral/contralateral).
- Rotatory vertigo was significantly higher in patients with TM perforation, open cavity mastoidectomy, and adhesive otitis media (74%) compared to those without (10%).
Conclusions:
- Microsuction-induced vertigo is likely caused by endolymph convection in the lateral semicircular canal due to cooling.
- While nystagmus is common, vertigo incidence depends on TM condition.
- Clinicians must monitor for vertigo and explore preventive strategies.
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