Clin Exp Otorhinolaryngol.  2018 Jun;11(2):102-108. 10.21053/ceo.2017.01277.

Relationship of Vertigo and Postural Instability in Patients With Vestibular Schwannoma

• Nam GS
• Jung CM
• Kim JH
• Son EJ

• KMID: 2412667
• DOI: http://doi.org/10.21053/ceo.2017.01277

Abstract

OBJECTIVES
Growth of vestibular schwannomas (VS) causes progressive vestibular symptoms and postural instability. Since the tumor grows slowly, compensation of decaying vestibular input may decrease subjective symptoms of dizziness. This study aims to estimate the relationship of subjective vestibular symptoms and objective postural instability in patients with VS.
METHODS
A retrospective review of 18 patients newly diagnosed with VS and with subjective vertigo symptoms was performed. The results of vestibular function tests including the sensory organization test (SOT) using computerized dynamic posturography, caloric test, and self-report measures of subjective dizziness handicap (Dizziness Handicap Inventory) and visual analogue scale were compared according to the onset of vertigo symptoms.
RESULTS
In VS patients, SOT showed decreased equilibrium score for all vestibular function related conditions, condition (C) 5 and 6, and composite (COMP) score. COMP scores were not correlated with visual analogue scale or Dizziness Handicap Inventory scores. Acute onset group included six patients and insidious onset group, 12 patients. Equilibrium scores for C5 and C6, and COMP scores were lower for insidious onset group, but the difference was not statistically significant.
CONCLUSION
Our findings confirmed postural instability is prevalent in VS patients. SOT parameters did not differ significantly between acute onset and insidious onset groups, but increased tumor size and canal weakness were noted in the insidious onset group. Clinicians should consider that postural instability is likely present even in patients who do not complain of acute vertigo, and appropriate counseling should be discussed with the patients.

Keyword

Acoustic Neuroma; Vertigo; Postural Balance; Posturography

MeSH Terms

Caloric Tests
Compensation and Redress
Counseling
Dizziness
Humans
Neuroma, Acoustic*
Postural Balance
Retrospective Studies
Vertigo*
Vestibular Function Tests

Figure

• 

  Fig. 1. Box-plots of postural instability-related variables: (A) ES C5, (B) ES C6, (C) VEST, and (D) COMP scores for the acute onset and insidious onset groups of vestibular schwannoma patients. Each box represents the lower (the 25th percentile) to the upper range (the 75th percentile) and contains the median value shown as a line across. The “whiskers” of the box extend to the farthest points that are not outliers (i.e., they are within 1.5 times the interquartile range of the 25th and 75th percentiles). Outside values are depicted as circle lines. ES, equilibrium score; C, condition; VEST, vestibular; COMP, composition.

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