Prognostic Factors of Balance Quality After Transpetrosal Vestibular Schwannoma Microsurgery

Thomeer, Hans G. X. M.; Bonnard, D.; Franco-Vidal, V.; Porez, Florence; Darrouzet, Patricia; Liguoro, Dominique; Darrouzet, V.

doi:10.1097/mao.0000000000000740

Cited by 10 publications

(8 citation statements)

References 19 publications

(14 reference statements)

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“…There were no significant differences between groups in DHI scores pre-operatively and 3 months postoperatively, and the same was true for the vertigo intensity questionnaire pre-operatively at 3 weeks and 3 months post-operatively. This result differs from a report in which central signs affected DHI scoring 11 . Our results are in line with that of the larger group of schwannoma patients in whom DHI deteriorated from preoperative values to higher scores at three months after surgery.…”

Section: Discussioncontrasting

confidence: 99%

“…With respect to the presence of spontaneous nystagmus and abnormal deviation of subjective visual vertical (SVV) at 3 weeks and 3 months after surgery, our study did not find a significant difference between patients with central parameters pre-operatively. These results are in agreement with other studies 411 .…”

Section: Discussionsupporting

confidence: 94%

“…A central oculomotor pathology can be found, especially in patients with cerebellar dysfunction 410 . In this study, 29 patients (61.7%) had central abnormalities, which is higher than other reports 1211 , because most tumours were stages 3 or 4, which we assume represented cerebellar compression.…”

Section: Discussioncontrasting

confidence: 66%

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Predictors of central vestibular compensation after surgery for vestibular schwannomas

Čada

Balatková

Čakrt

et al. 2019

Acta Otorhinolaryngol Ital

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SUMMARY Surgical removal of vestibular schwannoma causes acute vestibular symptoms, including postoperative vertigo which is the most negative factor affecting quality of life in patients after vestibular schwannoma surgery. The main aim of this study is to determine whether the results from routine electronystagmography with pathological visually-provoked responses can predict poor postoperative compensation. We also investigate whether postoperative central compensation is related to objective parameters such age, tumour size, length of surgery and persistent nystagmus. According to the results from preoperative electronystagmography, patients were divided into three groups: peripheral, central and combined vestibular syndrome. Signs of central compensation were evaluated by the presence of postoperative nystagmus, vertigo, deviation of subjective visual vertical and head impulse test. There were no statistically significant differences between groups in observed signs of compensation. These results suggest that pathological central oculomotor parameters are not a negative predictive factor for central vestibular compensation.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionsupporting

confidence: 94%

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Predictors of central vestibular compensation after surgery for vestibular schwannomas

Čada

Balatková

Čakrt

et al. 2019

Acta Otorhinolaryngol Ital

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“…Finally, this meta‐analysis could not consider all of the important factors that might affect the balance function of VS patients. Factors that affect vestibular function and compensation include tumor size, patient age, and tumor biology . Balance is affected by vestibular function and by emotional status and characteristics of dizziness .…”

Section: Discussionmentioning

confidence: 99%

Comparison of balance outcomes according to treatment modality of vestibular schwannoma

2019

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Objectives: We sought to compare balance outcomes according to treatment modality of vestibular schwannoma (VS) via a meta-analysis that divided measuring tools of balance outcomes into three categories based on type.Methods: A comprehensive review of the literature from January 1966 to September 2017 was performed, looking for studies about long-term balance outcomes after microsurgery (MS), radiotherapy (RT), or observation for VS. A comprehensive meta-analysis was used to analyze effect sizes, explore possible causes of heterogeneity, and check publication bias with a funnel plot and Egger's regression.Results: Among 633 references, 34 were included in the meta-analysis. Perceived dizziness improvement rate was significantly higher in the MS group than in the RT group (odds ratio [OR]: 1.61; 95% confidence interval [CI]: 1.08 to 2.40; P < .05, I 2 = 4.18], but no significant difference was observed between the two groups with regard to validated dizziness questionnaire score (standardized mean difference: 0.04; 95% CI: −0.36 to 0.44; P = .84, I 2 = 69.61) or dizziness or disequilibrium-related symptom incidence rate (OR: 0.91; 95% CI: 0.50 to 1.68; P = .77, I 2 = 0). In a subanalysis conducted within the groups after intervention, the MS group demonstrated a lower vertigo incidence rate (P < .001), and the RT group experienced a significant reduction in validated dizziness questionnaire score (P < .05).Conclusions:Our results indicate that MS should be considered at least equal to RT in regard to resolving long-term dizziness and improving balance outcomes. Furthermore, well-designed studies are necessary to predict balance outcomes after VS treatment and to choose from among possible treatment options.

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“…34 -36 Postoperative imbalance/vestibulopathy associated with certain tumors such as schwannomas or cerebellar tumors may respond to vestibular therapies, particularly when the treatment is initiated in the early postoperative period. 34,36 Fatigue and poor endurance or exercise tolerance may be caused by adverse effects of chemotherapy, radiation, Review medications, deconditioning, metabolic problems, infection, anemia, depression, impaired sleep, and/or nutritional factors. Some of these problems are more easily treated than others.…”

Section: Rehabilitation Of Multifactorial Motor Symptomsmentioning

confidence: 99%

Rehabilitation of motor dysfunction in primary brain tumor patients†

Kushner

Amidei

2015

Neuro-Oncology Practice

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In 2010 it was estimated that >688 000 Americans were living with a primary brain tumor (PBT) corresponding to a U.S. prevalence rate of approximately 221.8 per 100 000 people. Five-year survival is 96.1% in nonmalignant PBTs, 34% in malignant PBTs for all ages, and 71% in children [1985–2005]. Case fatality rates have decreased in the U.S. since the 1970's for nonmalignant PBTs and for medulloblastoma, oligodendroglioma, and astrocytoma. Statistics of increasing survival highlight the importance of rehabilitation interventions to improve function and quality of life in survivors. PBT motor dysfunction is multifactorial, occurring as a result of direct effects of tumor and/or swelling or as a result of treatments; etiologies include encephalopathy, myopathy, neuropathy, infection, poor nutrition, metabolic factors, emotional factors, impaired perception/vision/cognition and complications of immobility. Motor dysfunction may lead to: impaired mobility, impaired activities of daily living, risk for complications of immobility, falls, pain, anxiety/depression, and loss of functional independence and quality of life. Rehabilitation treatment strategies target specific causes of motor dysfunction to improve functional independence and quality of life. This article reviews current knowledge and controversy regarding the role of rehabilitation for motor disorders in PBT patients.

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Prognostic Factors of Balance Quality After Transpetrosal Vestibular Schwannoma Microsurgery

Abstract: VS microsurgery provides good stability results. Some preoperative parameters may be predictive of worse or improved balance recovery, as is clinical status on D7.

Cited by 10 publications

References 19 publications

Predictors of central vestibular compensation after surgery for vestibular schwannomas

Predictors of central vestibular compensation after surgery for vestibular schwannomas

Comparison of balance outcomes according to treatment modality of vestibular schwannoma

Rehabilitation of motor dysfunction in primary brain tumor patients†

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