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Ask the DoctorsHearing & Balance Center

Is it normal to have severe vertigo after surgery?

Question: Is it normal to have severe vertigo after middle ear surgery? I recently had a tympanotomy & stapedectomy, and now I am experiencing the symptoms of vertigo. If this is the case, how long does it usually last?
Thank you
Answer:
Thank you for your inquiry. Even though it can occur, it is not normal to have severe vertigo after having middle ear surgery. Some degree of lightheadedness and unsteadiness is common after surgery. But when it comes to any kind of surgical procedure, there are possible risks and complications that can occur.
When the symptoms of vertigo do occur it may reflect irritation of the inner ear. Careful treatment can help prevent a poor hearing outcome. In many instances, treatment includes rest, eating a well-balanced diet, and practicing the avoidance of loud noise. While a stapedectomy typically restores partial or total hearing in almost 95% of cases, for that 5% that fails, revision surgery may be necessary to solve the problem. In the case of experiencing severe vertigo after a stapedectomy, exploration of the middle ear should always be performed by a hearing specialist.
In some instances, experiencing vertigo after middle ear surgery could be related to a perilymphatic fistula. When a perilymph fistula is present, there is an abnormal opening (usually a tear or some type of defect) between the inner and the middle ear. When there is a tear present, it causes fluid to leak into the middle ear. Treatment for a perilymph fistula often requires strict bed rest, which will allow your body to repair the tear on its own. However, if symptoms do not improve your doctor may suggest surgical repair of the perilymph fistula. Going the surgical route can help prevent your symptoms from getting worse.
Seeing an audiologist regarding your symptoms is highly recommended.
Neil Sperling

Frequently Asked Questions

Severe vertigo is not considered normal after middle ear surgery, although some lightheadedness and unsteadiness can occur. Severe vertigo may indicate irritation or complications involving the inner ear, and it should be evaluated by a hearing specialist promptly.

Vertigo after these surgeries may be caused by irritation of the inner ear or a condition called perilymphatic fistula, which is an abnormal opening allowing fluid to leak between the inner and middle ear. This can lead to symptoms like vertigo and requires medical assessment.

The duration of vertigo after middle ear surgery varies, but initial symptoms can improve with rest, a balanced diet, and noise avoidance. If vertigo persists or is severe, it may require further intervention such as bed rest or surgical repair to resolve underlying issues like a perilymphatic fistula.

Treatment often starts with rest, a well-balanced diet, and avoiding loud noises. If vertigo is related to complications like a perilymphatic fistula, strict bed rest or surgical intervention may be necessary to repair the inner ear and prevent worsening symptoms.

A perilymphatic fistula is an abnormal tear or defect between the inner and middle ear, causing fluid leakage that can result in vertigo. It can occur after middle ear surgeries, and treatment typically involves bed rest or, if needed, surgical repair to close the opening.

If you experience severe or persistent vertigo following middle ear surgery, it is important to consult an audiologist or hearing specialist. They can determine if further testing or treatment, such as revision surgery, is necessary to address complications.

Dr Robert Pincus

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