Humphriss Rachel L, Baguley David M, Moffat David A
Department of Audiology, Addenbrooke's Hospital, Cambridge, England, UK.
Otol Neurotol. 2003 Jul;24(4):661-5. doi: 10.1097/00129492-200307000-00021.
To evaluate the change in dizziness handicap after translabyrinthine vestibular schwannoma excision.
Prospective administration of the Dizziness Handicap Inventory preoperatively and at 3 and 12 months postoperatively; retrospective review of case notes.
A tertiary referral neuro-otology clinic.
A total of 100 consecutive patients who had vestibular schwannomas excised between June 1998 and November 2001 and who had completed Dizziness Handicap Inventories preoperatively and at 3 and 12 months postoperatively.
Translabyrinthine excision of a unilateral sporadic vestibular schwannoma; preoperative and postoperative generic vestibular rehabilitation exercises.
Dizziness Handicap Inventory scores.
For most patients, dizziness handicap does not worsen postoperatively. However, for those in whom it does, dizziness handicap becomes significantly worse between preoperative and 3-month postoperative time points but then does not continue to decline. Tumor size, sex, and magnitude of preoperative canal paresis significantly affect the degree of change in handicap. Age, the presence of central vestibular system abnormalities, and the nature of the patient's principal presenting symptom have no effect on this handicap change.
These findings help the clinician in counseling the patient preoperatively about dizziness handicap to be expected postoperatively. In particular, the clinician is now able to take an informed and positive stance in the event of a severe canal paresis preoperatively.
评估经迷路前庭神经鞘瘤切除术后头晕障碍的变化。
前瞻性地在术前、术后3个月和12个月使用头晕障碍量表；回顾病例记录。
一家三级转诊神经耳科诊所。
共有100例连续患者，于1998年6月至2001年11月期间接受了前庭神经鞘瘤切除术，且在术前、术后3个月和12个月完成了头晕障碍量表评估。
经迷路切除单侧散发性前庭神经鞘瘤；术前和术后进行一般性前庭康复训练。
头晕障碍量表评分。
对于大多数患者，术后头晕障碍并未加重。然而，对于那些头晕障碍加重的患者，头晕障碍在术前至术后3个月的时间点之间显著恶化，但之后并未继续下降。肿瘤大小、性别和术前半规管轻瘫程度显著影响障碍变化程度。年龄、是否存在中枢前庭系统异常以及患者主要症状的性质对这种障碍变化没有影响。
这些发现有助于临床医生在术前向患者咨询术后预期的头晕障碍情况。特别是，临床医生现在能够在术前出现严重半规管轻瘫的情况下采取明智且积极的态度。
