JOURNAL ARTICLE

Early adaptation and compensation of clinical vestibular responses after unilateral vestibular deafferentation surgery

Georgios Mantokoudis, Michael C Schubert, Ali S Saber Tehrani, Aaron L Wong, Yuri Agrawal
Otology & Neurotology 2014, 35 (1): 148-54
23965525

OBJECTIVE: To describe vestibulo-ocular function in the immediate postoperative period after unilateral vestibular deafferentation from vestibular schwannoma resection.

STUDY DESIGN: Prospective longitudinal study.

SETTING: Tertiary medical center.

PATIENTS: Five patients who underwent vestibular schwannoma resection via retrosigmoid approach.

INTERVENTIONS: Bedside video-oculography and video head impulse testing (HIT).

MAIN OUTCOME MEASURES: Static and dynamic measures of vestibulo-ocular reflex (VOR) function including spontaneous nystagmus, skew deviation, VOR gain during HIT, and presence of saccades related to HIT.

RESULTS: Mean ipsilesional horizontal VOR gain decreased from 0.88 ± 0.09 preoperatively to 0.27 ± 0.20 on POD 2 (p = 0.004). Mean contralesional VOR gain declined from 0.95 ± 0.1 preoperatively to 0.79 ± 0.17 on POD 2 (p = 0.032). By POD 4, ipsilesional VOR gain remained low, whereas contralesional VOR gain returned to baseline. Initially on POD 1 to 3, compensatory saccades occurred exclusively after the head stopped moving (overt) with latency of 192.8 ± 36.1 ms; by POD 5, saccade latency decreased to 134.5 ± 23.5 ms (p = 0.026), and saccades were occurring during the head rotation. Skew deviation was present and remained abnormal through POD 5 in 3 of the 5 patients.

CONCLUSION: In the postoperative period, gaze stability seems to improve from contralesional VOR gain restoration and reduced latency of compensatory saccades.

Full Text Links

Find Full Text Links for this Article

Discussion

You are not logged in. Sign Up or Log In to join the discussion.

Related Papers

Remove bar
Read by QxMD icon Read
23965525
×

Save your favorite articles in one place with a free QxMD account.

×

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"