Background: Surgical treatment of vestibular schwannoma (VS) leads to acute ipsilateral vestibular loss if there is residual vestibular function before surgery. To overcome the sequelae of acute ipsilateral vestibular loss and to decrease postoperative recovery time, the concept of preemptive vestibular ablation with gentamicin and vestibular prehabilitation before surgery has been developed ("vestibular prehab").
Objective: Studying postural stability during walking and handicap of dizziness over a 1-year follow-up period in VS patients undergoing vestibular prehab before surgical treatment of VS.
Methods: A retrospective review of consecutive patients with a diagnosis of a VS undergoing surgical therapy from June 2012 to March 2018 was performed. All patients were included with documentation of the length of hospital duration and the Dizziness Handicap Inventory (DHI) and the Functional Gait Assessment (FGA) assessed preoperatively as well as 6 weeks and 1 year postoperatively.
Results: A total 68 VS patients were included, of which 29 patients received preoperative vestibular ablation by intratympanic injection of gentamicin. Mean VS diameter was 20.2 mm (SD 9.4 mm) and mean age at surgery was 49.6 years (SD 11.5 years). Vestibular prehab had no effect on DHI and FGA at any time point studied.
Conclusions: We found no effect of vestibular prehab on postural stability during walking and on the handicap of dizziness. These findings add to the body of knowledge consisting of conflicting results of vestibular prehab. Therefore, vestibular prehab should be applied only in selected cases in an experimental setting.
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Postural stability and handicap of dizziness after preoperative vestibular ablation and vestibular prehabilitation in patients undergoing vestibular schwannoma resection.
J Vestib Res
March 2022
Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Zurich, Zurich, Switzerland.
Background: Surgical treatment of vestibular schwannoma (VS) leads to acute ipsilateral vestibular loss if there is residual vestibular function before surgery. To overcome the sequelae of acute ipsilateral vestibular loss and to decrease postoperative recovery time, the concept of preemptive vestibular ablation with gentamicin and vestibular prehabilitation before surgery has been developed ("vestibular prehab").
Objective: Studying postural stability during walking and handicap of dizziness over a 1-year follow-up period in VS patients undergoing vestibular prehab before surgical treatment of VS.
PREHAB vs. REHAB - presurgical treatment in vestibular schwannoma surgery enhances recovery of postural control better than postoperative rehabilitation: Retrospective case series.
J Vestib Res
September 2018
Department of Otorhinolaryngology, Head and Neck Surgery, Skåne University Hospital, Lund, Sweden.
Object: To evaluate post-surgical postural stability when treating patients with remaining vestibular function with intratympanic gentamicin (PREHAB) prior to schwannoma surgery.
Method: 44 consecutive patients with some form remaining vestibular function scheduled for vestibular schwannoma surgery. 20 were medically deafferented with intratympanic gentamicin before surgery and 24 were not.
Hearing and Vestibular Function After Preoperative Intratympanic Gentamicin Therapy for Vestibular Schwanomma as Part of Vestibular Prehab.
Ear Hear
January 2018
1Department of Otorhinolaryngology, Head and Neck Surgery, and 2Department of Neurosurgery Clinical Sciences, Skåne University Hospital, Lund, Sweden.
Objective: To evaluate auditory and vestibular function after presurgical treatment with gentamicin in schwannoma patients.
Background: The vestibular PREHAB protocol aims at diminishing the remaining vestibular function before vestibular schwannoma surgery, to ensure less acute symptoms from surgery, and initiate a more efficient vestibular rehabilitation already before surgery. However, the potential cochleotoxicity of gentamicin is a concern, since modern schwannoma surgery strives to preserve hearing.
'PREHAB': Vestibular prehabilitation to ameliorate the effect of a sudden vestibular loss.
NeuroRehabilitation
February 2012
Department of Otorhinolaryngology and Neurosurgery, Lund University, Lund University Hospital, Lund, Sweden.
A sudden unilateral loss or impairment of vestibular function causes vertigo, dizziness and impaired postural function. In most occasions, everyday activities supported or not by vestibular rehabilitation programs will promote compensation and the symptoms subside. As the compensatory process requires sensory input, matching performed motor activity, both motor learning of exercises and matching to sensory input are required.
View Article and Find Full Text PDFVestibular "PREHAB".
Ann N Y Acad Sci
May 2009
Department of Otorhinolaryngology, Lund University Hospital, Lund University, 221 85 Lund, Sweden. n.
Article Synopsis
- A sudden loss of vestibular function can lead to symptoms like vertigo and dizziness, but working on compensatory exercises can help alleviate these issues over time.
- If there's also damage to the cerebellum during surgery or due to a tumor, patients may struggle to compensate, leading to more severe and lasting symptoms.
- "PREHAB," a pre-treatment plan involving vestibular exercises, was introduced to minimize symptoms and enhance recovery for patients undergoing treatments like gentamicin or surgery for vestibular issues, showing positive results in improving balance and reducing complications.
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