Postural control after vestibular schwannoma resection measured with visual feedback posturography.
BACKGROUND
Vestibular symptoms after surgery diminish rapidly, but the simultaneous progress in active postural control has not been fully addressed.


OBJECTIVE
The aim was to evaluate the progress in postural control in operated vestibular schwannoma (VS) patients with visual feedback posturography (VFP).


METHODS
36 consecutive patients with unilateral VS were studied with the VFP pre-operatively, 1 month and 3 months after the surgery. The accuracy and velocity of active postural control movements to distant targets in VFP was measured and compared to that of healthy controls.


RESULTS
The hold percentage within the targets was significantly reduced in the VS patients compared to the controls (pre-operatively p = 0.005; postoperatively at 1 month p = 0.002 and at 3 months p = 0.017). The sway velocity (SV) within the targets among patients with VS was significantly increased pre-operatively (p = 0.009), at the 1-month (p = 0.004) and at the 3-month follow-up visits (p = 0.016). All the postural control parameters except SV tended to improve slightly postoperatively. The consecutive VFP measurements in individual VS patients correlated statistically significantly (p < 0.001 for all parameters). The abnormality in the pre-operative VFP results correlated statistically significantly with that of postoperative VFP (p = 0.001).


CONCLUSIONS
The VFP is an objective and repeatable method, which can be used to assess and follow up the active postural control in individual patients with VS. Persisting abnormality in the VFP seems to be an indication for more aggressive vestibular rehabilitation to normalize the disturbed postural control.
Hirvonen
Meeli
M
Department of Otolaryngology, Helsinki University Central Hospital, Finland.
Aalto
Heikki
H
Hirvonen
Timo P
TP
D000328:Adult; D000368:Aged; D001676:Biofeedback, Psychology; D004584:Electronystagmography; D004867:Equipment Design; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009464:Neuroma, Acoustic / Q000601:surgery*; D010775:Photic Stimulation / Q000295:instrumentation*; D004856:Postural Balance; D011187:Posture; D011446:Prospective Studies; D012027:Reflex, Vestibulo-Ocular / Q000502:physiology; D014796:Visual Perception