Impacts of small vestibular schwannoma on community ambulation, postural, and ocular control

Low Choy, Nancy L., Lucey, Mary-Therese M., Lewandowski, Susan L. and Panizza, Benedict J. (2016) Impacts of small vestibular schwannoma on community ambulation, postural, and ocular control. Laryngoscope, 127 5: 1147-1152. doi:10.1002/lary.26105

Author Low Choy, Nancy L.
Lucey, Mary-Therese M.
Lewandowski, Susan L.
Panizza, Benedict J.
Title Impacts of small vestibular schwannoma on community ambulation, postural, and ocular control
Journal name Laryngoscope   Check publisher's open access policy
ISSN 1531-4995
Publication date 2016-08-13
Year available 2016
Sub-type Article (original research)
DOI 10.1002/lary.26105
Open Access Status Not yet assessed
Volume 127
Issue 5
Start page 1147
End page 1152
Total pages 6
Place of publication Hoboken, NJ, United States
Publisher John Wiley & Sons
Language eng
Formatted abstract
Objectives/Hypothesis: To investigate balance, community mobility, gaze instability, and dizziness handicap and assess falls risk in people who are conservatively managed with small vestibular schwannoma (VS).

Study Design: Cross-sectional study with controls.

Methods: The study involved 18 people (mean age 58.7 ± 12.2 years) diagnosed with VS (<12 mm) and 22 age-matched controls (mean age 56.9 ± 8.0 years). Measures included standing on firm and foam surfaces with feet apart, then together with eyes open and closed, Timed Up and Go (TUG) test and dual TUG test, Dynamic Gait Index, 6-Minute Walk Test, Halmagyi Impulse Test, Dynamic Visual Acuity Test, and the Dizziness Handicap Inventory.

Results: The clinical group failed more trials standing feet together on foam with eyes closed (P < .05); had inferior mobility and walked more slowly with divided attention (P < .05); had more difficulty walking with head movement, negotiating obstacles, and using stairs (P < .01); and walked shorter distances (P < .001) than controls. Reduced gaze stability (P < .01) and higher total (P = .007) and subcategory dizziness handicap scores (P < .05) were revealed compared to age-matched controls.

Conclusions: Although outcomes for the clinical group are inferior to the control group across all measures and the dizziness impact is higher, the results fall in the low-risk category for falls. Preliminary data (level 4 evidence) support using a suite of clinical measures to monitor people with VS during conservative management.
Keyword Vestibular
Quality of life
Vestibular schwannoma
Conservative management
Vestibulo-ocular control
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

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Created: Wed, 05 Oct 2016, 08:40:04 EST by Dr Benedict Panizza on behalf of Surgery - Princess Alexandra Hospital