Limited data are available on the effects of otosclerosis and otosclerosis surgery on the utricle and saccule. This study aimed to determine the effect of otosclerosis and stapedotomy on vestibular-evoked myogenic potentials.

This retrospective study included 16 otosclerosis patients and 18 controls. Thirty-two ears of 16 patients with otosclerosis were divided into 2 groups based on whether the ear had been operated on or not. All patients and subjects underwent 500 Hz air- and bone-conducted ocular and cervical vestibular-evoked myogenic potentials testing.

Overall comparison of response rates showed a significant difference among the groups. Further statistical tests showed that this difference arose from differences between both operated and unoperated groups and the control group, for air-conducted cervical and ocular vestibular-evoked myogenic potentials.

Otosclerosis and stapedotomy may affect the elicitability of vestibular-evoked myogenic potentials. Otosclerosis is associated with lower response rates for air-conducted ocular and cervical vestibular-evoked myogenic potentials, regardless of whether operated on. Having been operated on does not significantly increase the response rate of air-conducted vestibular-evoked myogenic potentials.

Auditory implantation into the inner ear is increasingly performed for a variety of indications. Infective complications are rare, but when they occur they can have devastating consequences.

This paper reports two cases where vestibular sequestration of the bony labyrinth developed following implantation into the middle ear.

To the authors' knowledge, these are the first reported cases where vestibular sequestration has resulted from auditory implant surgery. This paper outlines the radiological changes characteristic of this pathology. It also describes the surgical and conservative treatment options for this condition, challenging the previously accepted belief that affected patients always require aggressive surgical intervention.

This report describes a novel case in which superior canal dehiscence syndrome was unmasked by successful stapes surgery for otosclerosis.

Case report and literature review regarding superior canal dehiscence syndrome.

Superior canal dehiscence syndrome is a rare but well described condition in which audiovestibular symptoms are caused by noise or straining. A dehiscence of the superior semicircular canal in the floor of the middle cranial fossa is responsible, and acts as a ‘third window’ into the inner ear.

A patient with confirmed otosclerosis underwent second-side stapedotomy, with good audiometric outcomes. Unfortunately, surgery was complicated by immediate post-operative vertigo and persistent auditory symptoms. A diagnosis of superior canal dehiscence syndrome was eventually made, on the basis of low threshold vestibular evoked myogenic potentials and characteristic computed tomography findings. Superior canal resurfacing resulted in complete resolution of symptoms.

The otosclerotic focus in the oval window prevented the development of symptoms from this patient's superior canal dehiscence syndrome. Surgical stapedotomy created a third window and resulted in immediate post-operative imbalance and auditory symptoms.

The diagnosis of superior canal dehiscence syndrome should be considered in patients with persistent audiovestibular symptoms after stapes surgery. High resolution computed tomography of the temporal bone and vestibular evoked myogenic potential testing, if available, are the investigations of choice in confirming the diagnosis.

To evaluate distortion product otoacoustic emissions following stapes surgery in patients with otosclerosis, and to compare in this respect two surgical techniques used in our department.

This retrospective study included 17 stapedectomy and 23 stapedotomy patients aged 16–68 years who had been followed up for at least 12 months. Distortion product otoacoustic emission results at 2, 3, 4 and 5 kHz (i.e. =f2, with 2f1 − f2 = 0.6f2) were obtained pre-operatively and four weeks post-operatively. The control group included 13 volunteers aged 18–50 years with normal hearing and normal otoscopic findings.

Distortion product otoacoustic emissions were detected pre-operatively in 34.8 per cent of stapedotomy patients and 29.4 per cent of stapedectomy patients, and post-operatively in 91.3 per cent of stapedotomy patients and 88.2 per cent of stapedectomy patients. The differences between the stapedotomy and stapedectomy groups were statistically insignificant for each tested frequency, both pre- and post-operatively. The patients' post-operative distortion product otoacoustic emission amplitudes were less than those of normal hearing individuals, even in patients with complete air–bone gap closure and a significant improvement in hearing.

Distortion product otoacoustic emissions were detected in most of our patients following successful stapes surgery, and appeared to be unaffected by the surgical technique or prosthesis used.