Vertigo after stapes surgery: the role of high resolution CT.

Abstract

CT findings in patients with vertigo after stapes surgery include a prosthesis shaft entering the vestibule and compressing the saccule, a complete dislocation of the stapes prosthesis, air bubbles and fluid collections within the vestibule and outside the oval window indicating a perilymphatic fistula, and bony fragments leading to compression of the basal saccule. Although immediate post-operative vertigo is often transient, patients with persistent or recurrent vertigo should be imaged as high resolution CT will determine the underlying cause in the majority of cases.

Analysis of the accuracy of high-resolution computed tomography techniques for the measurement of stapes prostheses

“…However, the accuracy of these measurements for this foreign material has not yet been adequately explored in the literature [13]. Whereas the authors Hahn et al and Warren et al are sceptical of the accuracy of CT imaging and specifically question the accuracy of measurement of the depth of vestibular penetration, other research groups appear to be convinced of the need for CT measurement of the penetration depth [9][10][11][12]14].…”

Flat panel CT following stapes prosthesis insertion: an experimental and clinical study

“…B Frequency-specific average ABG improvement after otosurgery. Data shown are mean ± SEM of vertigo following stapesplasty as shown in other studies [18]. Although the direct proof by fpCT is favourable, this technique also allows indirect measurement of the prosthesis penetration depth when the otosurgeon's information about the used prosthesis length is present.…”

“…Unfortunately standard CT is susceptible to metallic artefacts and possible partial volume effects which aggravate the outlining of delicate structures like e.g. stapes prostheses [18]. These restrictions impair precise localisation and differentiation of delicate structures across the temporal bone, especially metallic prostheses and/or the ossicular chain.…”

Stellenwert der CT-Diagnostik vor Revisions-Stapedotomien

“…Sie gibt Auskunft über die Lage, die Eindringtiefe und den möglichen Typ der Prothese [11]. Bei einer postoperativen Schwindelsymptomatik müssen neben einer intravestibulären Lage der Prothese eine Perilymphfistel oder Granulationen im Bereich des ovalen Fensters in die Differenzialdiagnose miteinbezogen werden [22].…”