Einfluss der mikroneurochirurgischen Operation bei Akustikusneurinom auf dessen Symptome Schwindel und Tinnitus

Heerma, Heike; Braun, Veit; Richter, Hans-Peter

doi:10.1007/s001060050583

Cited by 7 publications

(3 citation statements)

References 19 publications

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“…The authors claim that this may be due to a more complete dysfunction of the vestibular nerve in the high-dose group. Another study reports a higher incidence of pre-treatment vertigo in patients with small and medium-sized VSs as compared to large schwannomas (>4 cm; Heerma et al, 2000). In a detailed description of the sensorimotor postural rearrangement after unilateral vestibular deafferentation in patients with VS, Parietti-Winkler et al (2006) found a poorer postural performance of patients before surgery compared to that found 3 months post-operative.…”

Section: Discussionmentioning

confidence: 98%

“…However, only few studies were conducted in a prospective way (Myrseth et al, 2009). Furthermore, although vertigo, dizziness, and unsteadiness of gait are common symptoms of VS (reported incidence between 49 and 66%), these symptoms were often only assessed in a qualitative or semi-quantitative way (El-Kashlan et al, 1998; Lynn et al, 1999; Heerma et al, 2000; Inoue et al, 2001; Humphriss et al, 2003). …”

Section: Introductionmentioning

confidence: 99%

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Vestibular function and quality of life in vestibular schwannoma: does size matter?

Wagner

Glaser

Wowra³

et al. 2011

Front. Neur.

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Objectives: Patients with vestibular schwannoma (VS) frequently suffer from disabling vestibular symptoms. This prospective follow-up study evaluates vestibular and auditory function and impairment of quality of life due to vertigo, dizziness, and imbalance in patients with unilateral VS of different sizes before/after microsurgical or radiosurgical treatment. Methods: Thirty-eight patients with unilateral VS were included. Twenty-two received microsurgery, 16 CyberKnife radiosurgery. Two follow-ups took place after a median of 50 and 186.5 days. Patients received a standardized neuro-ophthalmological examination, electronystagmography with bithermal caloric testing, and pure-tone audiometry. Quality of life was evaluated with the Dizziness Handicap Inventory (DHI). Patient data was grouped and analyzed according to the size of the VS (group 1: <20 mm vs group 2: ≥20 mm). Results: In group 1, the median loss of vestibular function was +10.5% as calculated by Jongkees Formula (range −43 to +52; group 2: median +36%, range −56 to +90). The median change of DHI scores was −9 in group 1 (range −68 to 30) and +2 in group 2 (−54;+20). Median loss of hearing was 4 dB (−42; 93) in group 1 and 12 dB in group 2 (5; 42). Conclusion: Loss of vestibular function in VS clearly correlates with tumor size. However, loss of vestibular function was not strictly associated with a long-term deterioration of quality of life. This may be due to central compensation of vestibular deficits in long-standing large tumors. Loss of hearing before treatment was significantly influenced by the age of the patient but not by tumor size. At follow-up 1 and 2, hearing was significantly influenced by the size of the VS and the manner of treatment.

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Section: Discussionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

Vestibular function and quality of life in vestibular schwannoma: does size matter?

Wagner

Glaser

Wowra³

et al. 2011

Front. Neur.

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“…There is a growing interest in developing methods to accurately assess the quality of life (QOL) of patients with VS (2)(3)(4)(5)(6). Vertigo and unsteady gait in those with VS are reported to have an incidence rate ranging from 49 to 66% (7)(8)(9)(10)(11). It is therefore not surprising that balance has been cited as the most significant predictor of QOL for the VS patient population (12)(13)(14)(15).…”

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confidence: 99%

The Relationship Between the Functional Gait Assessment and Quality-of-Life Data in Patients Undergoing Vestibular Schwannoma Resection

Said

Lee

Moshtaghi

et al. 2021

Otology &Amp; Neurotology

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Objective: To examine the relationship between the Functional Gait Assessment (FGA) and quality of life (QOL) measurements relating to balance before and after vestibular schwannoma (VS) resection and to assess the role of preoperative FGA in predicting postoperative QOL. Study Design: A prospective clinical study of adult patients undergoing VS resection between September 2018 and December 2019. FGA was administered 1 week before and after surgery. Dizziness Handicap Inventory (DHI) and Penn Acoustic Neuroma Quality of Life (PANQOL) were administered preoperatively and at 3 months postoperatively. Setting: Single tertiary center. Patients: Patients (age ≥ 18 years old) with VS undergoing microsurgical resection. Excluded were patient with previous surgery or radiation. Intervention: VS resection. Main Outcomes and Measures: Primary outcome: correlation between FGA and QOL surveys. Secondary outcome: correlation between preoperative measurements of balance and postoperative PANQOL. Results: One hundred thirty-eight patients were analyzed (mean age: 48 years old, 65.9% female). The translabyrinthine approach was most commonly performed. Under multivariate analysis, preoperative FGA significantly correlated with preoperative PANQOL balance score (p < 0.0001), preoperative PANQOL total score (p = 0.0002), and preoperative DHI (p < 0.0001). However, postoperative FGA did not significantly correlate with postoperative PANQOL balance or total scores (p = 0.446 and p = 0.4, respectively), or postoperative DHI (p = 0.3). Univariate analysis demonstrated that preoperative DHI and preoperative FGA were predictive of changes in postoperative PANQOL balance and total scores. However under multivariate analysis, preoperative FGA did not predict changes in postoperative PANQOL balance or total score (p = 0.24; p = 0.28, respectively). Preoperative DHI remained predictive of changes in postoperative PANQOL balance (p = 0.03) score but not of postoperative PANQOL total score (p = 0.37). Conclusions: Although FGA and QOL data significantly correlated in the preoperative setting, our results did not suggest that preoperative FGA can be used to determine postoperative QOL. Additionally, the lack of correlation between FGA and QOL measurements in the acute postoperative setting suggests that further research is needed to determine contributors to postoperative QOL.

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Predicting Functional Outcomes and Length of Stay Following Acoustic Neuroma Resection

et al. 2020

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Objectives To examine whether simple mobility assessments can predict functional limitations and length of hospitalization after acoustic neuroma (AN) resection. Study design Prospective case series. Methods A prospective clinical study of adult patients undergoing AN resection by either the translabyrinthine, retrosigmoid, or middle fossa approach was conducted at a tertiary center. Preoperative mobility assessments included the functional gait assessment (FGA) and the 10‐m walk (10 MW). Postoperatively, the Activity Measure for Post‐Acute Care (AMPAC, at 48 hours), FGA, and 10 MW (at 1 week) were obtained. Demographic and medical data were collected. Results One hundred and thirty‐eight patients were analyzed (mean age: 48.3 years, 68.8% female). Mean length of stay (LOS) was 3.1 days. The translabyrinthine approach was most commonly performed (48.6%). On regression analyses, preoperative FGA (P = 0.03) and 48‐hour postoperative AM‐PAC (P < 0.001) independently predicted LOS, even after accounting for age, gender, body mass index, and tumor size. On receiver operating characteristic analysis, a preoperative FGA cut score of 25.5 predicted a protracted hospital stay (>4 days) with a sensitivity of 77% and specificity of 50% (area under curve: 68.5). Conclusion This study demonstrated that preoperative mobility assessments can predict functional limitations and LOS after AN resection. These objective tools can be used by clinicians to manage expectations and guide preoperative counseling in patients considering surgery. Level of Evidence 3 Laryngoscope, 131:644–648, 2021

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Einfluss der mikroneurochirurgischen Operation bei Akustikusneurinom auf dessen Symptome Schwindel und Tinnitus

Cited by 7 publications

References 19 publications

Vestibular function and quality of life in vestibular schwannoma: does size matter?

Vestibular function and quality of life in vestibular schwannoma: does size matter?

The Relationship Between the Functional Gait Assessment and Quality-of-Life Data in Patients Undergoing Vestibular Schwannoma Resection

Predicting Functional Outcomes and Length of Stay Following Acoustic Neuroma Resection

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