Zuzana Balatková

Cochlear implant (CI) electrode placement inside the cochlea without any insertion complication is a key step in a CI surgery for a successful CI treatment (Friedland & Runge-Samuelson, 2009). The ...

The purpose of this study was to evaluate vestibular function in adolescents with idiopathic scoliosis (IS). We examined 20 patients with IS and 20 healthy controls. The examination involved assessment of the perception of subjective visual vertical (SVV) in static and dynamic conditions, posturography (6 conditions: eyes open/closed, firm/foam surface, tandem stand), and vestibular evoked myogenic potential (VEMP) testing. Results of the tests were compared between the groups. In SVV, there was no significant difference in static conditions. However, in dynamic conditions, the deviation was significantly greater in patients than in controls (P < .05). Posturography parameters of patients were significantly greater (P < .05) when standing on a foam surface with eyes open. In this condition, patients had greater center of foot pressure sway area and sway velocity. The patients and controls also differed in terms of sway path, sway velocity, and maximal amplitude in the medial-lateral direction. In VEMP testing, 38% of patients with IS had an abnormal response. This study showed greater variations in dynamic SVV, greater values of posturography parameters, and some abnormal VEMP responses in patients with IS. It is not yet known if vestibular rehabilitation can improve these abnormal functions.

Objective: Resection of the vestibular schwannoma causes acute peripheral vestibular loss. The process of central compensation starts immediately afterward. The rehabilitation goal is to support this process and restore the quality of life. Materials and methods: In this prospective single-center study, 67 consecutive patients underwent vestibular schwannoma resection (40 females, mean age 52 ± 12 years). The patients were divided into three groups: the prehabilitation with intratympanic gentamicin group, the virtual reality group (optokinetic stimulation via virtual reality goggles in the first ten days after the surgery), and the control group. All patients were examined with objective methods and completed questionnaires before the prehabilitation, before the surgery, at the hospital discharge, and after three months. Results: Intratympanic gentamicin prehabilitation leads ipsilaterally to a significant aVOR reduction in all semicircular canals (p < 0.050), the increase of the unilateral weakness in air calorics (p = 0.026), and loss of cVEMPs responses (p = 0.017). Prehabilitation and postoperative exposure to virtual reality scenes improved the patient’s perception of vertigo problems according to Dizziness Handicap Inventory (p = 0.039 and p = 0.076, respectively). These findings conform with the optokinetic testing results, which showed higher slow phase velocities at higher speeds (40 deg/s) in both targeted groups compared to the control group. Conclusion: Preoperative intratympanic gentamicin positively affects peripheral vestibular function, influencing balance perception after VS resection. In long-term follow-up, prehabilitation and postoperative exposure to virtual reality improve patients’ quality of life in the field of vertigo problems.