Effects of vestibulo-ocular reflex exercises on vestibular compensation after vestibular schwannoma surgery

Otol Neurotol. 2005 Mar;26(2):265-9. doi: 10.1097/00129492-200503000-00024.


Objective: To assess vestibular function in a large group of vestibular schwannoma patients so that we could determine whether simple vestibular exercises speed vestibular dysfunction recovery after tumor removal surgery.

Study design: A prospective investigation of the vestibular dysfunction experienced by patients in the first 12 weeks after surgery.

Setting: Vestibular investigation unit at a tertiary referral institution.

Patients: Sixty-five patients with identified vestibular schwannoma referred for preoperative vestibular investigations. Thirty-two men and 33 women, with a mean age 51 years (range, 24-77 yr).

Interventions: There were 27 control patients, 30 exercise patients, and 8 patients that had balance physiotherapy. Exercise patients began simple vestibulo-ocular reflex gaze stabilization exercises 3 days after surgery.

Main outcome measures: Postoperative vestibular function testing was performed at 2 to 3, 6 to 7, and 10 to 12 weeks after surgery. Objective measurements of vestibular compensation status were as follows: spontaneous nystagmus and sinusoidal harmonic acceleration asymmetry and gain values. Dizziness Handicap Inventory questionnaires were used to assess subjective perceptions.

Results: The main findings were reduced dispersion in vestibulo-ocular reflex asymmetry at 2 to 3 weeks, reduced mean in asymmetry at 6 to 7 weeks, less dizziness/imbalance according to the Dizziness Handicap Inventory questionnaire, and that preoperative caloric tests did not predict postoperative severity of vestibular systems.

Conclusion: This large study provided unique evidence that a program of simple vestibular exercises and education can speed the rate of compensation after vestibular schwannoma surgery.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Electronystagmography
  • Female
  • Humans
  • Male
  • Neuroma, Acoustic / surgery*
  • Outcome and Process Assessment, Health Care
  • Physical Therapy Modalities
  • Postoperative Complications / physiopathology*
  • Postural Balance / physiology
  • Prospective Studies
  • Reflex, Vestibulo-Ocular / physiology*
  • Vestibular Function Tests
  • Vestibule, Labyrinth / physiopathology*