Evaluation of the potential risk of benign paroxysmal positional vertigo due to traumatic effect of osteotomy in septorhinoplasty patients.

Abstract Purpose To investigate the effect of osteotomy on the vestibular system in septorhinoplasty patients and to determine the potential risk of benign paroxysmal positional vertigo (BPPV) occurrence in these patients. Methods In this prospective study, 48 primary septorhinoplasty patients were evaluated as the study group and 50 septoplasty patients as the control group. Osteotomy was performed in all septorhinoplasty patients. No hammer and osteotomes were used in the control group. All patients underwent static balance tests (tandem stance test, one-leg standing test, and Romberg test), dynamic balance tests (tandem walking test and Fukuda test), positional balance tests (Dix-Hallpike test and supine roll test), head impulse test (HIT), and the adult dizziness handicap inventory (ADHI) preoperatively and during the first postoperative week. Results No significant differences were found between the two groups in terms of static balance tests, dynamic balance tests, positional balance tests, and head impulse test results. Postoperative ADHI scores were significantly worse in the septorhinoplasty patient group than in the control group. Posterior semicircular canal BPPV was observed in 2 patients in the septorhinoplasty patient group but no cases occurred in the control group. Conclusion BPPV is one of the possible early postoperative complications of rhinoplasty. In patients with vertigo after rhinoplasty, surgeons should evaluate the semicircular canals using the Dix-Hallpike test and supine roll test. In order to avoid the traumatic effect of osteotomy reflected on the inner ear, attention should be paid to the applied force and sharp osteotomes should be used.