Pre-operative vestibular pattern and balance compensation after vestibular schwannoma surgery

Prognostic Factors of Balance Quality After Transpetrosal Vestibular Schwannoma Microsurgery

“…These suspected factors could be preoperative such as age, hearing, tumor size, or caloric deficit, or immediately postoperative such as vestibular symptoms and diplopia. Caloric areflexia is known to be predictive of good vestibular compensation (3). The study was original in that it prospectively assessed these factors and included some not investigated so far, like the presence of a cystic component in the tumor, cVEMP amplitude, SVV deviation, preop hearing level, and postop diplopia.…”

Preoperative balance control compensation in patients with a vestibular schwannoma: Does tumor size matter?

“…These results with the selected patients support the hypothesis that postural compensation does not parallel vestibular compensation. This dissociation is even more pronounced when higher cognitive process are involved (Parietti-Winkler et al, 2011). Indeed, ensuring stability in sensory conflict conditions requires both adaptive and learning mechanisms to adjust balance, which implicates the central structures and neural pathways beyond the vestibular nuclei (Gauchard et al, 2013).…”

“…Indeed, individual characteristics, such as age (Gauchard et al, 2012), preoperative preference of visual cues to control balance (Parietti-Winkler et al, 2008), preoperative practice of physical activities (Gauchard et al, 2001;Gauchard et al, 2013), and/or VS-related characteristics, such as origin of the tumor on the vestibular nerve (Gouveris et al, 2006;Borgmann et al, 2011) and preoperative vestibular pattern (Parietti-Winkler et al, 2011) can have a positive or negative impact on balance performances at a given postoperative evaluation stage. For example, Parietti-Winkler et al (2011) revealed that patients with preoperative vestibular areflexy did not display postural performance degradation just after surgery and showed a large improvement in postural performances three months after surgery, in contrast to patients with vestibular normoreflexy who followed the classic postural performance kinetics. Moreover, the authors demonstrated that patients with vestibular areflexy had lower preoperative postural performances compared to others.…”

“…Moreover, the authors demonstrated that patients with vestibular areflexy had lower preoperative postural performances compared to others. Parietti-Winkler et al (2011) hypothesized that a preoperative vestibular dysfunction related to tumor growth triggered an implementation of the central adaptive processes before the surgery, which allowed for partial anticipation of the negative effects on balance regulation that occurred with the surgical removal of the tumor.…”

“…Parietti-Winkler et al (2011) hypothesized that the preand postoperative postural performances depend on, among other things, vestibular function that can be impaired by tumor growth. However, the influence of the size of the tumor on the postural performance has not been investigated.…”