title: Nausea and dizziness after vestibular schwannoma surgery: a multivariate analysis of preoperative symptoms.
abstract: OBJECTIVE
  Nausea and dizziness are very discomforting for patients after vestibular schwannoma surgery and they impair recovery.
  
  
  METHODS
  To identify preoperative symptoms and conditions that increase the risk of development of nausea after vestibular schwannoma surgery, a multivariate analysis was performed. One hundred fifteen patients with vestibular schwannoma had a microsurgical tumor removal in a standardized procedure in 2001 and 2002. Eighteen patients were excluded from the study because of previous surgery (recurrent tumors, 7 patients) or bilateral tumor occurrence (neurofibromatosis, 11 patients). Analysis was performed regarding postoperative amount of antiemetic medication, vomiting, and subjective feeling of the patient. Tumor grading, body mass index, sex, previous complaints, examination at admission, and side of the tumor were taken in consideration.
  
  
  RESULTS
  Women had significant longer postoperative complaints (mean, 3.0 d; standard error, 0.47) and needed longer antiemetic therapy (mean, 3.3 d; standard error, 0.49) than men (mean, 1.72 d; standard error, 0.21). Patients developing no significant postoperative complaints were all in the higher tumor grading group, Grades 3a, 4a, and 4b. There was a significant difference in the duration of antiemetic therapy between tumors graded 1 and tumors graded 3 or 4. Patients with a positive stepping test preoperatively had a tendency to demand less antiemetic medication. Women with small tumors are most likely to develop significant complaints after vestibular schwannoma surgery.
  
  
  CONCLUSIONS
  It is possible to identify patients with a higher risk of postoperative nausea and dizziness after vestibular schwannoma surgery. This allows one to inform these patients preoperatively and to initiate an early postoperative drug therapy to ease their symptoms.
authors.affiliation: Medical School of Hannover, Hannover, Germany.
authors.forename: Lennart H
authors.initials: LH
authors.lastname: Stieglitz
authors.forename: Amir
authors.initials: A
authors.lastname: Samii
authors.forename: Jan
authors.initials: J
authors.lastname: Kaminsky
authors.forename: Alireza
authors.initials: A
authors.lastname: Gharabaghi
authors.forename: Madjid
authors.initials: M
authors.lastname: Samii
authors.forename: Wolf O
authors.initials: WO
authors.lastname: Lüdemann
mesh_terms: D000328:Adult; D000368:Aged; D004244:Dizziness / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009325:Nausea; D009464:Neuroma, Acoustic / Q000503:physiopathology / Q000601:surgery*; D013506:Otologic Surgical Procedures / Q000009:adverse effects*; D011183:Postoperative Complications; D020250:Postoperative Nausea and Vomiting / Q000209:etiology*; D012189:Retrospective Studies; D012737:Sex Factors; D013997:Time Factors