OBJECTIVE: Vestibular schwannoma surgery leads to acute unilateral vestibular loss. In some patients, however, the process of post-operatively initiated central compensation proceeds more rapidly than in others. This study aimed to evaluate post-operative vestibular function and correlate it with morphological findings of MRI scans. METHODS: The study included 29 patients who underwent surgery for vestibular schwannoma. Vestibular function was analysed post-operatively by video head impulse test (vHIT). Subjective symptoms were evaluated using validated questionnaires. All patients underwent MRI 3 months post-operatively, and the presence of the facial and vestibulocochlear nerves in the internal auditory canal was assessed. RESULTS: The vestibulo-ocular reflex gain measured by the vHIT correlated positively with audiological findings. Subjective perception of vestibular disorder did not correlate with objectively measured vestibular impairment or with MRI findings. CONCLUSIONS: After the resection of vestibular schwannoma, some patients may still have preserved vestibular function as measured by vHIT. The preserved function does not correlate with subjective symptoms. Patients with partially deteriorated vestibular function showed lower sensitivity to combined stimuli.

UNLABELLED: Dopo chirurgia del neurinoma vestibolare la funzione vestibolare correla con dati oggettivi estratti dalla risonanza magnetica? OBIETTIVO: La chirurgia dello schwannoma vestibolare causa un deficit vestibolare unilaterale acuto. Tuttavia, in alcuni pazienti il processo di compenso centrale post-operatorio progredisce più rapidamente rispetto ad altri. Il presente studio è finalizzato a valutare la funzione vestibolare post-operatoria e correlarla con i dati morfologici della risonanza magnetica. METODI: Lo studio analizza 29 pazienti sottoposti a chirurgia per schwannoma vestibolare. La funzione vestibolare è stata analizzata nel post-operatorio con il “video head impulse test” (vHIT). I sintomi soggettivi sono stati indagati mediante questionari validati. Tutti i pazienti sono stati sottoposti a risonanza magnetica 3 mesi dopo l’intervento, e su questo esame è stata determinata la presenza dei nervi facciale e vestibolo-cocleare nel canale uditivo interno. RISULTATI: Il riflesso vestibolo-oculare misurato con il vHIT correla positivamente con i dati audiologici. La percezione soggettiva dei sintomi vestibolari non correla né con i dati oggettivi di deficit vestibolare né con le immagini della risonanza magnetica. CONCLUSIONI: Dopo la resezione di uno schwannoma vestibolare i pazienti possono ancora preservare la funzione vestibolare, come è stato misurato con il vHIT. L’entità della funzione preservata non correla con i sintomi soggettivi. I pazienti con una funzione vestibolare parzialmente deteriorata mostrano una minor sensibilità agli stimoli combinati.

Department of Anthropomotorics and Methodology Faculty of Physical Education and Sport Charles University Prague Czech Republic

Department of Neurology 2nd Faculty of Medicine Charles University and Motol University Hospital Post graduate Medical School Prague Czech Republic

Department of Otorhinolaryngology and Head and Neck Surgery 1st Faculty of Medicine Charles University and Motol University Hospital Post graduate Medical School Prague Czech Republic

Department of Otorhinolaryngology and Head and Neck Surgery 2nd Faculty of Medicine Charles University and Motol University Hospital Prague Czech Republic

Department of Otorhinolaryngology and Head and Neck Surgery Havířov Hospital Czech Republic

Department of Radiology Na Homolce Hospital Prague Czech Republic

Department of Rehabilitation and Sports Medicine 2nd Faculty of Medicine Charles University and Motol University Hospital Prague Czech Republic

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