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Abstract of the Week Summary of the Month

Summary of May 2019 Topic: Vestibular Schwannoma

The topic for May was Vestibular Schwannoma. The first article looked at the functional effect of persons with vestibular schwannoma who were managed conservatively, without surgery etc. Several balance measures showed inferior balance and mobility of the group with vestibular schwannoma. Despite this variance those with schwannoma still had a low fall risk and supports monitoring this population with balance outcome measures. (1)

The next article examined the efficacy of diagnosis of unilateral vestibular schwannoma using both vHIT and caloric testing. 20/30 subjects with diagnosed vestibular schwannoma demonstrated a hypofunction via calorics but only 10/30 had an abnormal gain indicating a unilateral hypofunction using the vHIT. (2)

The next article evaluated the type of schwannoma's effect on vestibular function. The larger cystic tumors had more of a negative impact on gain. (3)

The final article assessed saccades via a PR score, measure of scatter and refixation of saccades, before and after surgical resection of 36 patients with vestibular schwannomas. Patients with worse pre-op dysfunction had faster compensation after surgery. PR score could be used to evaluate recovery post-op. (4)

1. Low Choy NL, Lucey MM, Lewandowski SL, Panizza BJ. Impacts of small vestibular schwannoma on community ambulation, postural, and ocular control. Laryngoscope. 2017 May;127(5):1147-1152. doi: 10.1002/lary.26105. Epub 2016 Aug 13.

2. Tranter-Entwistle I, Dawes P, Darlington CL, Smith PF, Cutfield N. Video head impulse in comparison to caloric testing in unilateral vestibular schwannoma. Acta Otolaryngol. 2016 Nov;136(11):1110-1114. Epub 2016 May 25.

3. Constanzo F, Teixeira BCA, Sens P, Ramina R. Video Head Impulse Test in Vestibular Schwannoma: Relevance of Size and Cystic Component on Vestibular Impairment. Otol Neurotol. 2019 Apr;40(4):511-516. doi: 10.1097/MAO.0000000000002158.

4. Batuecas-Caletrio A, Rey-Martinez J, Trinidad-Ruiz G, Matiño-Soler E, Cruz-Ruiz SS, Muñoz-Herrera A, Perez-Fernandez N. Vestibulo-Ocular Reflex Stabilization after Vestibular Schwannoma Surgery: A Story Told by Saccades. Front Neurol. 2017 Jan 25;8:15. doi: 10.3389/fneur.2017.00015. eCollection 2017.

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