title: Vestibular compensation following vestibular neurotomy.
abstract: OBJECTIVE
  Four studies assessing vestibular compensation in Menière's disease patients undergoing unilateral vestibular neurotomy, using different analysis methods, are reviewed, with a focus on the different strategies used by patients according to their preoperative sensory preference.
  
  
  METHODS
  Four prospective studies performed in a university tertiary referral center were reviewed, measuring the pattern of vestibular compensation in Menière's disease patients before and after unilateral vestibular neurotomy on various assessment protocols: postural syndrome assessed on static posturography and gait analysis; perceptual syndrome assessed on subjective visual vertical perception; and oculomotor syndrome assessed on ocular cyclotorsion.
  
  
  RESULTS
  Vestibular compensation occurred at variable intervals depending on the parameter investigated. Open-eye postural control and gait/walking returned to normal one month after neurotomy. Fine balance analysis found that visual perception of the vertical and ocular cyclotorsion impairment persisted at long-term follow-up. Clinical postural disturbance persisted only when visual afferents were cut off (eyes closed). These impairments were the expression of a postoperative change in postural strategy related to the new use of visual and non-visual references.
  
  
  CONCLUSIONS
  Understanding pre-operative interindividual variation in balance strategy is critical to screening for postural instability and tailoring vestibular rehabilitation.
authors.affiliation: Service d'oto-rhino-laryngologie et d'otoneurologie, hôpital Nord, CHU, Assistance publique-Hôpitaux de Marseille, chemin des Bourrelly, 13915 Marseille cedex 20, France; Aix Marseille University. Laboratoire de Biomécanique Appliquée, IFSTTAR UMR T24, Boulevard Pierre Dramard, 13015 Marseille, France. Electronic address: Arnaud.Deveze@mail.ap-hm.fr.
authors.forename: A
authors.initials: A
authors.lastname: Devèze
authors.affiliation: Service d'oto-rhino-laryngologie et d'otoneurologie, hôpital Nord, CHU, Assistance publique-Hôpitaux de Marseille, chemin des Bourrelly, 13915 Marseille cedex 20, France; Aix Marseille University. Laboratoire de Biomécanique Appliquée, IFSTTAR UMR T24, Boulevard Pierre Dramard, 13015 Marseille, France.
authors.forename: M
authors.initials: M
authors.lastname: Montava
authors.affiliation: Aix Marseille University, Laboratoire de neurobiologie intégrative et adaptative, CNRS UMR 6149, 3, place Victor-Hugo, 13331 Marseille cedex 03, France.
authors.forename: C
authors.initials: C
authors.lastname: Lopez
authors.affiliation: Aix Marseille University, Laboratoire de neurobiologie intégrative et adaptative, CNRS UMR 6149, 3, place Victor-Hugo, 13331 Marseille cedex 03, France.
authors.forename: M
authors.initials: M
authors.lastname: Lacour
authors.affiliation: Service d'oto-rhino-laryngologie et d'otoneurologie, hôpital Nord, CHU, Assistance publique-Hôpitaux de Marseille, chemin des Bourrelly, 13915 Marseille cedex 20, France; Aix Marseille University, Laboratoire de neurobiologie intégrative et adaptative, CNRS UMR 6149, 3, place Victor-Hugo, 13331 Marseille cedex 03, France.
authors.forename: J
authors.initials: J
authors.lastname: Magnan
authors.affiliation: Aix Marseille University, Laboratoire de neurobiologie intégrative et adaptative, CNRS UMR 6149, 3, place Victor-Hugo, 13331 Marseille cedex 03, France.
authors.forename: L
authors.initials: L
authors.lastname: Borel
mesh_terms: D000222:Adaptation, Physiological; D006801:Humans; D008575:Meniere Disease / Q000601:surgery*; D019635:Neurosurgical Procedures; D011434:Proprioception / Q000502:physiology*; D014725:Vestibular Nerve / Q000601:surgery*; D014785:Vision, Ocular / Q000502:physiology; D016138:Walking / Q000502:physiology
keywords: Menière's disease; Postural recovery; Unilateral vestibular neurotomy; Vestibular compensation; Visual dependency