Can Dizziness Handicap Inventory and Activities-Specific Balance Confidence Scores Assess Vestibular Loss After Vestibular Schwannoma Excision?

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Otology and Neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology


OBJECTIVE: Evaluate and compare the Dizziness Handicap Inventory with Activities-specific Balance Confidence scores shortly after vestibular schwannoma excision. STUDY DESIGN: Retrospective database review. SETTING: Tertiary care center. PATIENTS: Adults undergoing vestibular schwannoma excision between January 2015 and December 2019. INTERVENTION: Diagnostic, therapeutic, and rehabilitative. MAIN OUTCOME MEASURES: Postoperative change in Dizziness Handicap Inventory scores and Activities-specific Balance Confidence scores 2 to 3 weeks after surgical intervention in relation to preoperative vestibular testing. RESULTS: A total of 49 patients met inclusion criteria. The average change in the Dizziness Handicap Inventory was 6 (p = 0.07, 95% CI 0-13). This was weakly correlated to preoperative caloric testing values (r = -0.31, p = 0.03), but not cervical vestibular evoked myogenic potentials (cVEMP) values (r = -0.17, p = 0.23). The average change in Activities-specific Balance Confidence was -10% (p = 0.007, 95% CI -3 to -17%). This change was moderately correlated with preoperative caloric values (r = 0.42, p = 0.006), but it was not correlated with cVEMP (r = 0.07, p = 0.66). CONCLUSIONS: In vestibular schwannoma patients, factors other than preoperative vestibular function likely affect postoperative Dizziness Handicap Inventory and Activities-specific Balance Confidence scores. The change in Activities-specific Balance Confidence was slightly more consistent with expected physiological vestibular loss, and it represents another tool in a multidisciplinary vestibular evaluation of the postoperative patient.

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