Audiovestibular Outcomes After Parathyroidectomy in Primary Hyperparathyroidism.

IF 1.9 4区医学 Q2 OTORHINOLARYNGOLOGY

Laryngoscope Investigative Otolaryngology Pub Date : 2026-08-06 eCollection Date: 2026-08-01 DOI:10.1002/lio2.70533

Erdem Köroğlu, Halil Erdem Özel, Seda Erem Basmaz, Melikşah Çakır

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Abstract

Objective: To prospectively evaluate audiovestibular outcomes following parathyroidectomy in patients with primary hyperparathyroidism (pHPT) using a comprehensive battery of audiological, vestibular, and patient-reported outcome measures.

Methods: This prospective observational study included 31 adult patients undergoing parathyroidectomy for pHPT caused by parathyroid adenoma. Assessments were performed preoperatively and at prespecified postoperative time points: audiometry at month 1; vHIT, VNG, and VDI at week 1 and month 1; and SVV on day 2, week 1, and month 1. The primary outcome was change in VDI score following surgery.

Results: Hearing thresholds remained stable after surgery, with no significant changes in conventional or extended high-frequency audiometric measurements. SVV values remained within normal limits throughout follow-up, and VNG revealed no clinically significant abnormalities. vHIT gains were largely unchanged, although statistically significant differences were observed in left lateral canal gain (p = 0.032) and anterior canal asymmetry (p = 0.003); all values remained within normative ranges. Mean VDI scores improved significantly following surgery (38.1 ± 31.0 vs. 25.7 ± 26.8; p = 0.001), indicating reduced dizziness-related disability. None of the patients with preoperative BPPV (12.9%) reported recurrent positional vertigo symptoms during postoperative follow-up.

Conclusions: Parathyroidectomy was associated with significant improvement in subjective vestibular symptoms and reduced dizziness-related disability, despite largely stable objective audiological and vestibular findings. These results suggest that metabolic correction in pHPT may improve vestibular symptom perception through mechanisms not fully captured by conventional audiovestibular testing. Further studies with larger cohorts and longer follow-up are needed to clarify the long-term effects of parathyroidectomy on vestibular function.

Level of evidence: 4.

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原发性甲状旁腺功能亢进患者行甲状旁腺切除术后听庭预后。

目的：通过综合听力学、前庭学和患者报告的结果测量，前瞻性评估原发性甲状旁腺功能亢进（pHPT）患者行甲状旁腺切除术后的听庭预后。方法：本前瞻性观察研究纳入31例因甲状旁腺瘤引起的pHPT行甲状旁腺切除术的成年患者。术前和术后预定时间进行评估：第1个月听力学；第1周、第1个月vHIT、VNG、VDI；第2天、第1周和第1个月的SVV。主要观察指标为术后VDI评分的变化。结果：术后听力阈值保持稳定，常规或扩展高频听力测量无明显变化。在随访期间SVV值保持在正常范围内，VNG未显示有临床意义的异常。vHIT增益基本没有变化，尽管在左外侧椎管增益（p = 0.032）和前椎管不对称（p = 0.003）方面观察到统计学上的显著差异；各项指标保持在规范范围内。手术后平均VDI评分显著提高（38.1±31.0比25.7±26.8;p = 0.001），表明眩晕相关残疾减少。术前BPPV患者（12.9%）在术后随访中无复发性眩晕症状。结论：甲状旁腺切除术与主观前庭症状的显著改善和头晕相关残疾的减少相关，尽管客观听力学和前庭检查结果基本稳定。这些结果表明，pHPT的代谢纠正可能通过常规听觉前庭测试未完全捕获的机制改善前庭症状感知。进一步的研究需要更大的队列和更长时间的随访来阐明甲状旁腺切除术对前庭功能的长期影响。证据等级：4。

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