Abstract
We reviewed the details of the clinical history of 31 patients with vertigo who had been operated on by (modified) radical mastoidectomy. Fifteen patients continued to experience dizziness, which was divided into three types.1) paroxysmal vertigo (3 cases), which resembled the first attack of Meniere's disease; 2) positional vertigo (5 cases); and 3) unsteadiness, provoked by rapid body movement or visual fatigue in some patients.Although the main cause of these dizzy spells was labyrinthitis due to the accumulation of keratinizing substance in the open cavity, a more detailed explanation seemed to be possible, according to the results of the examinations. The mechanism of paroxysmal vertigo, non-progressive endo-lymphatic hydrops (Schuknecht) seemed to be the most likely one, and positional vertigo might be explained by degenerative changes in the membranous labyrinth. However, merely pathological changes of the labyrinth could not account for the dizziness of type 3.The percentage of patients who continued to experince dizziness (48%) was higher than in former reports. Moreover, the percentage of those with the true rotatory vertigo types 1 and 2 among these 15 patients (53%) was higher than in former reports, although these reports described mainly preoperative findings. Our results should be considered when canal wall down methods are employed in order to prevent chronic infection from penetrating into the labyrinth during mastoidectomy.
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