Effects of vestibulo-ocular reflex exercises on vestibular compensation after vestibular schwannoma surgery.
OBJECTIVE
To assess vestibular function in a large group of vestibular schwannoma patients so that we could determine whether simple vestibular exercises speed vestibular dysfunction recovery after tumor removal surgery.


METHODS
A prospective investigation of the vestibular dysfunction experienced by patients in the first 12 weeks after surgery.


METHODS
Vestibular investigation unit at a tertiary referral institution.


METHODS
Sixty-five patients with identified vestibular schwannoma referred for preoperative vestibular investigations. Thirty-two men and 33 women, with a mean age 51 years (range, 24-77 yr).


METHODS
There were 27 control patients, 30 exercise patients, and 8 patients that had balance physiotherapy. Exercise patients began simple vestibulo-ocular reflex gaze stabilization exercises 3 days after surgery.


METHODS
Postoperative vestibular function testing was performed at 2 to 3, 6 to 7, and 10 to 12 weeks after surgery. Objective measurements of vestibular compensation status were as follows: spontaneous nystagmus and sinusoidal harmonic acceleration asymmetry and gain values. Dizziness Handicap Inventory questionnaires were used to assess subjective perceptions.


RESULTS
The main findings were reduced dispersion in vestibulo-ocular reflex asymmetry at 2 to 3 weeks, reduced mean in asymmetry at 6 to 7 weeks, less dizziness/imbalance according to the Dizziness Handicap Inventory questionnaire, and that preoperative caloric tests did not predict postoperative severity of vestibular systems.


CONCLUSIONS
This large study provided unique evidence that a program of simple vestibular exercises and education can speed the rate of compensation after vestibular schwannoma surgery.
Enticott
Joanne C
JC
Departments of Otolaryngology, The University of Melbourne, East Melbourne, Australia. enticott@unimelb.edu.au
O'leary
Stephen J
SJ
Briggs
Robert J S
RJ
D000293:Adolescent; D000328:Adult; D000368:Aged; D004584:Electronystagmography; D005260:Female; D006801:Humans; D008297:Male; D009464:Neuroma, Acoustic / Q000601:surgery*; D010043:Outcome and Process Assessment, Health Care; D026741:Physical Therapy Modalities; D011183:Postoperative Complications / Q000503:physiopathology*; D004856:Postural Balance / Q000502:physiology; D011446:Prospective Studies; D012027:Reflex, Vestibulo-Ocular / Q000502:physiology*; D014724:Vestibular Function Tests; D014722:Vestibule, Labyrinth / Q000503:physiopathology*