Author(s)
Mehdi Abouzari, MD PhD
Erica M. Parker, BS
Brooke Sarna, BS
Monica Trent, BS
Khodayar Goshtasbi, BS
Donald Tan, BA
Catherine Merna, MD
Hamid R. Djalilian, MD
Affiliation(s)
Department of Otolaryngology and Biomedical Engineering, University of California, Irvine
Abstract:
Educational Objective: At the conclusion of this presentation, the participants should be able to discuss the benefits of tympanostomy tube placement in patients with vertigo exacerbated by seemingly small changes in atmospheric pressure. Objectives: To evaluate tympanostomy tube placement in patients with pressure change induced vertigo. Study Design: Case series and review of the literature. Methods: Five patients with pressure sensitive vertigo underwent placement of tympanostomy tube. The patients most commonly had vertigo before thunderstorms, travel to elevation, or on airplanes. The vertigo episodes lasted between 30 minutes and 6 hours. The main outcome was reported resolution of pressure change induced vertigo. There was no precedent event that triggered the problem (e.g., strong Valsalva, heavy lifting, scuba diving, etc.) and all had a negative fistula test. Results: All patients reported resolution of their vertigo and other vestibular symptoms after placement of the tympanostomy tubes. All recurrences of symptoms were due to either extrusion or plugging of the tubes. All patients fulfilled the criteria for vestibular migraine. None of the patients had superior canal dehiscence on imaging. Conclusions: Tympanostomy tube placement should be considered in selected patients with vertigo exacerbated by seemingly small changes in atmospheric pressure (e.g., just prior to thunderstorms, air travel, or driving to the mountains). By eliminating the capability of the tympanic membrane to sense changes in pressure, patients with pressure induced vertigo (in the absence of perilymph fistula or superior canal dehiscence) may have relief of their symptoms.