title: Vertigo Perception and Quality of Life in Patients after Surgical Treatment of Vestibular Schwannoma with Pretreatment Prehabituation by Chemical Vestibular Ablation.
abstract: Surgical removal of vestibular schwannoma causes acute vestibular symptoms, including postoperative vertigo and oscillopsia due to nystagmus. In general, the dominant symptom postoperatively is vertigo. Preoperative chemical vestibular ablation can reduce vestibular symptoms postoperatively. We used 1.0 mL of 40 mg/mL nonbuffered gentamicin in three intratympanic installations over 2 days, 2 months preoperatively in 10 patients. Reduction of vestibular function was measured by the head impulse test and the caloric test. Reduction of vestibular function was found in all gentamicin patient groups. After gentamicin vestibular ablation, patients underwent home vestibular exercising for two months. The control group consisted of 10 patients who underwent only home vestibular training two months preoperatively. Postoperative rates of recovery and vertigo in both groups were evaluated with the Glasgow Benefit Inventory (GBI), the Glasgow Health Status Inventory (GHSI), and the Dizziness Handicap Inventory questionnaires, as well as survey of visual symptoms by specific questionnaire developed by us. There were no statistically significant differences between both groups with regard to the results of questionnaires. Patients who received preoperative gentamicin were more resilient to optokinetic and optic flow stimulation (p< 0.05). This trial is registered with clinical study registration number NCT02963896.
authors.affiliation: Department of Otorhinolaryngology and Head and Neck Surgery, 1st Faculty of Medicine, Charles University and Motol University Hospital, Postgraduate Medical School, Prague, Czech Republic.
authors.forename: Zdeněk
authors.identifier: 0000-0001-6062-6820
authors.initials: Z
authors.lastname: Čada
authors.affiliation: Department of Otorhinolaryngology and Head and Neck Surgery, 1st Faculty of Medicine, Charles University and Motol University Hospital, Postgraduate Medical School, Prague, Czech Republic.
authors.forename: Zuzana
authors.initials: Z
authors.lastname: Balatková
authors.affiliation: Department of Otorhinolaryngology, 3rd Faculty of Medicine, University Hospital Kralovske Vinohrady, Charles University, Prague, Czech Republic.
authors.forename: Martin
authors.initials: M
authors.lastname: Chovanec
authors.affiliation: Department of Rehabilitation and Sports Medicine, 2nd Faculty of Medicine, Charles University and Motol University Hospital, Postgraduate Medical School, Prague, Czech Republic.
authors.forename: Ondřej
authors.initials: O
authors.lastname: Čakrt
authors.affiliation: Department of Otorhinolaryngology and Head and Neck Surgery, 1st Faculty of Medicine, Charles University and Motol University Hospital, Postgraduate Medical School, Prague, Czech Republic.
authors.forename: Silvie
authors.initials: S
authors.lastname: Hrubá
authors.affiliation: Department of Neurology, 2nd Faculty of Medicine, Charles University and Motol University Hospital, Postgraduate Medical School, Prague, Czech Republic.
authors.forename: Jaroslav
authors.initials: J
authors.lastname: Jeřábek
authors.affiliation: Department of Otorhinolaryngology and Head and Neck Surgery, 1st Faculty of Medicine, Charles University and Motol University Hospital, Postgraduate Medical School, Prague, Czech Republic.
authors.forename: Eduard
authors.initials: E
authors.lastname: Zvěřina
authors.affiliation: Department of Otorhinolaryngology and Head and Neck Surgery, 1st Faculty of Medicine, Charles University and Motol University Hospital, Postgraduate Medical School, Prague, Czech Republic.
authors.forename: Oliver
authors.initials: O
authors.lastname: Profant
authors.affiliation: Department of Otorhinolaryngology and Head and Neck Surgery, 1st Faculty of Medicine, Charles University and Motol University Hospital, Postgraduate Medical School, Prague, Czech Republic.
authors.forename: Zdeněk
authors.initials: Z
authors.lastname: Fík
authors.affiliation: Department of Anthropometrics and Methodology, Faculty of Physical Education and Sport, Charles University, Prague, Czech Republic.
authors.forename: Martin
authors.initials: M
authors.lastname: Komarc
authors.affiliation: Department of Otorhinolaryngology and Head and Neck Surgery, 1st Faculty of Medicine, Charles University and Motol University Hospital, Postgraduate Medical School, Prague, Czech Republic.
authors.forename: Jan
authors.identifier: 0000-0001-8772-317X
authors.initials: J
authors.lastname: Betka
authors.affiliation: Department of Otorhinolaryngology and Head and Neck Surgery, 1st Faculty of Medicine, Charles University and Motol University Hospital, Postgraduate Medical School, Prague, Czech Republic.
authors.forename: Jan
authors.initials: J
authors.lastname: Kluh
authors.affiliation: Department of Neurology, 2nd Faculty of Medicine, Charles University and Motol University Hospital, Postgraduate Medical School, Prague, Czech Republic.
authors.forename: Rudolf
authors.initials: R
authors.lastname: Černý
mesh_terms: D000328:Adult; D000368:Aged; D002150:Caloric Tests; D005260:Female; D005839:Gentamicins / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009464:Neuroma, Acoustic / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D011183:Postoperative Complications / Q000188:drug therapy / Q000503:physiopathology; D011788:Quality of Life; D011795:Surveys and Questionnaires; D014717:Vertigo / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D015837:Vestibular Diseases / Q000188:drug therapy* / Q000503:physiopathology; D014722:Vestibule, Labyrinth / Q000187:drug effects / Q000503:physiopathology
chemical_list: D005839:Gentamicins