title: Effects of microvascular decompression surgery on posture control: A case report in an elderly patient.
abstract: OBJECTIVE
  We report the case of an 84-year-old woman with neurovascular conflict of the left cochleovestibular nerve. Prior to surgery, the patient complained of positional vertigo and dizziness for the past two years, and marked instability. Hearing loss and tinnitus were reported on the left side. The aim of this study was to investigate the effects of microvascular decompression of the cochleovestibular nerve on posture control.
  
  
  METHODS
  Evaluation of cochleovestibular function and posture control was performed before and after surgery. Postural performance was analyzed in static and dynamic conditions, with and without vision, and with optokinetic stimulation. Perception of the static visual vertical (SVV) was recorded in darkness.
  
  
  RESULTS
  Positional vertigo and tinnitus disappeared immediately after the decompression. The SVV remained unchanged one week after the surgery. Speech intelligibility of the left ear was improved (30 dB), and the vestibular deficit on this side was also significantly reduced (54% versus 18%). However, the more spectacular result was the effect on postural control. This elderly patient improved her postural balance in both static and dynamic conditions, and became able to maintain her equilibrium in the more challenging dynamic conditions, with and without vision, as early as one week after the surgery, a postural performance that she had been unable to do preoperatively.
  
  
  CONCLUSIONS
  This work is the first to show that the postural deficits resulting from neurovascular conflict of the cochleovestibular nerve are strongly improved after microvascular decompression.
authors: Service ORL et chirurgie cervico-faciale, hôpital Nord Marseille, chemin des Bourrely, 13015 Marseille, France; Laboratoire de neurosciences intégratives et adaptatives UMR 7260, 3, place Victor-Hugo, site Saint-Charles, 13331 Marseille cedex 20, France. Electronic address: laurence.demanze@univ-amu.fr.
authors: L
authors: L
authors: Bernard-Demanze
authors: Service ORL et chirurgie cervico-faciale, hôpital Nord Marseille, chemin des Bourrely, 13015 Marseille, France.
authors: M
authors: M
authors: Elzière
authors: Service ORL et chirurgie cervico-faciale, hôpital Nord Marseille, chemin des Bourrely, 13015 Marseille, France.
authors: P A
authors: PA
authors: Oddon
authors: Service ORL et chirurgie cervico-faciale, hôpital Nord Marseille, chemin des Bourrely, 13015 Marseille, France; Aix Marseille université, IFSSTAR, LBA, UMR-T 24, 13344 Marseille, France.
authors: M
authors: M
authors: Montava
authors: Service ORL et chirurgie cervico-faciale, hôpital Nord Marseille, chemin des Bourrely, 13015 Marseille, France; Aix Marseille université, IFSSTAR, LBA, UMR-T 24, 13344 Marseille, France.
authors: J P
authors: JP
authors: Lavieille
mesh_terms: D000369:Aged, 80 and over; D003056:Cochlear Nerve / Q000601:surgery*; D004244:Dizziness / Q000601:surgery*; D005260:Female; D034381:Hearing Loss / Q000209:etiology; D006801:Humans; D061145:Microvascular Decompression Surgery / Q000379:methods*; D004856:Postural Balance; D013065:Speech Intelligibility; D014012:Tinnitus / Q000209:etiology; D016896:Treatment Outcome; D014717:Vertigo / Q000601:surgery*; D014725:Vestibular Nerve / Q000601:surgery*; D014796:Visual Perception
keywords: Compression microvasculaire; Conflit neurovasculaire; Control postural; Elderly patient; Microvascular decompression; Neurovascular conflict; Patient âgé; Posture control