Ribeyre Laurence, Frère Julien, Gauchard Gérome, Lion Alexis, Perrin Philippe, Spitz Elisabeth, Parietti-Winkler Cécile
Service d'Oto-Rhino-Laryngologie et de Chirurgie Cervico-Faciale, Centre Hospitalier Universitaire de Nancy, 54000 Nancy, France; Université de Lorraine and Université Paris Descartes, Laboratoire APEMAC «Maladies chroniques, santé perçue et processus d'adaptation. Approches épidémiologiques et psychologiques» (EA 4360), 54500 Vandœuvre lès Nancy, France.
Service d'Oto-Rhino-Laryngologie et de Chirurgie Cervico-Faciale, Centre Hospitalier Universitaire de Nancy, 54000 Nancy, France; Faculté de Médecine and UFR STAPS, Université de Lorraine, Laboratoire «Développement, Adaptation et Handicap» (EA 3450), 54500 Vandœuvre lès Nancy, France.
Clin Neurophysiol. 2015 Apr;126(4):787-93. doi: 10.1016/j.clinph.2014.07.022. Epub 2014 Aug 17.
The influence of tumor size on postural control of patients with vestibular schwannoma (VS) remains to be determined. This study aimed to compare the postural performances of VS patients, according to the size of the tumor, with healthy subjects.
The six conditions (C1-C6) of the sensory organization test (SOT) were carried out in 87 patients, split into four groups according to the Koos classification (stage I-IV), and in 72 aged-matched controls to evaluate postural control. The vestibular reflectivity and compensation were estimated with videonystagmography.
Among patients, lower C5 and C6 scores were found in stage I and IV patients than in stage II and III patients, whereas vestibular compensation did not impact the tumor size influence on the postural control. The scores were significantly (p<0.001) lower for all the groups of patients than the controls in the vestibular-related SOT conditions (C5-C6).
Patients with an unilateral VS displayed altered postural performances compared to the control subjects and tumor size had a bell-like pattern effect on balance control.
The tumor size could be seen as a determining factor in the implementation of adaptive mechanisms that lead to the postural compensation and might be dissociated from vestibular compensation.
前庭神经鞘瘤（VS）患者的肿瘤大小对其姿势控制的影响尚待确定。本研究旨在根据肿瘤大小，将VS患者与健康受试者的姿势表现进行比较。
对87例患者进行了感觉组织测试（SOT）的六种情况（C1 - C6），这些患者根据库斯分类法分为四组（I - IV期），并对72名年龄匹配的对照组进行测试，以评估姿势控制。通过视频眼震图评估前庭反射率和代偿情况。
在患者中，I期和IV期患者的C5和C6得分低于II期和III期患者，而前庭代偿并未影响肿瘤大小对姿势控制的影响。在与前庭相关的SOT情况（C5 - C6）中，所有患者组的得分均显著低于对照组（p < 0.001）。
与对照组相比，单侧VS患者的姿势表现发生改变，且肿瘤大小对平衡控制呈钟形模式影响。
肿瘤大小可被视为导致姿势代偿的适应性机制实施中的一个决定性因素，并且可能与前庭代偿无关。
