Evaluation of Vestibular Function in Chronic Otitis Media: Effects of Tympanoplasty and Tympanomastoidectomy via vHIT

Introduction: This study aimed to investigate the effects of surgical treatment (tympanoplasty or tympanomastoidectomy) on semicircular canal function in patients with COM using the vHIT, VOR gains before and one month after surgery. Materials and Methods:: A prospective observational study was conducted with 45 patients (21 males, 24 females; mean age 34.47 ± 12.44 years) diagnosed with unilateral COM who were scheduled for surgical intervention. Only patients with normal preoperative vHIT results were included. Vestibular assessment was performed with vHIT preoperatively and one month postoperatively, measuring VOR gains in all six semicircular canals. Patients were divided into two groups based on the surgical procedure: tympanoplasty (n=26) and tympanomastoidectomy (n=19). Statistical comparisons of VOR gain changes were made within and between groups using paired and independent tests. Results: Preoperative VOR gains in the affected ears were within normal limits across all canal planes (anterior: 0.91 ± 0.14, lateral: 0.96 ± 0.11, posterior: 0.93 ± 0.09), and remained stable postoperatively (anterior: 0.92 ± 0.11, lateral: 0.99 ± 0.10, posterior: 0.94 ± 0.10), with no statistically significant differences (p>0.05). No significant differences were found in VOR gain changes between surgical groups. All patients maintained normal VOR gain one month after surgery, consistent with the literature suggesting preserved vestibular function following COM surgery in patients with normal preoperative vHIT. Discussion: Surgical techniques for COM do not adversely affect high-frequency semicircular canal function when preoperative vHIT results are normal. Both tympanoplasty and tympanomastoidectomy are vestibular-safe procedures in this context. vHIT can be considered a valuable perioperative tool to assess vestibular integrity in COM, although additional testing is recommended in symptomatic cases.