Effects of Rhinoplasty on Labyrinthine Function

Overview

Nasal bone cuts are made by tapping a chisel with a mallet, and that vibration travels through the skull. The inner ear contains both the hearing organ and the balance organ. This study tested whether those vibrations measurably affect either.

Sections of note

• Study group: 30 adults who underwent rhinoplasty with osteotomies performed using a hammer.
• Control group: 10 age and gender matched adults who had nasal surgery without a surgical mallet or osteotome.
• Osteotomies are described as performed on the nasal bone, maxillary crest, or vomer.
• Both groups were tested before the operation and 1 week after.
• Tests used: pure tone audiometry, tympanometry, distortion product otoacoustic emission testing, vestibular-evoked myogenic potential, and video head impulse testing.
• No significant difference between groups in pure tone thresholds from 250 Hz to 8 kHz, P above 0.05, or in otoacoustic emissions.
• No significant difference in balance testing by vestibular-evoked myogenic potential or video head impulse test, before or after surgery, P above 0.05.

What it means for a patient

• Hammering during nose surgery did not measurably damage hearing or balance in this group.
• Testing covered both the hearing organ and the balance organ, using several different methods.
• Limits: 30 patients and only 10 controls, single center, and testing only 1 week after surgery, so delayed effects would not be detected.
• The study measured test results, not symptoms such as dizziness reported by patients.

Why this paper matters

Patients and surgeons have raised concern about skull vibration during osteotomy, and this addresses it with objective inner ear testing. The negative finding supports the safety of mallet osteotomy. The small control group and one-week window limit how firmly the result can be stated.

Terms

• Labyrinth: The inner ear structure containing the organs of hearing and balance.
• Osteotomy: A controlled surgical cut through bone.
• Osteotome: A chisel-like instrument used with a mallet to cut bone.
• Pure tone audiometry: A hearing test measuring the quietest sound heard at each frequency.
• Vestibular-evoked myogenic potential: A test of balance organ function measured through muscle responses.
• Vomer: A thin bone forming part of the nasal septum.