Otolith function after acoustic neuroma surgery

The response of the vestibular system after acoustic neuroma surgery was investigated in nine patients. The otolith system was studied by means of ocular counterrolling, assessed by video oculography. Horizontal vestibulo-ocular reflex (VOR) function was tested by the sinusoidal harmonic acceleration test using electronystagmography. The results were compared with those obtained from a normal control population. The response to slow rotation tests was symmetric, but the gain was significantly reduced when compared to the normal population. Phase lag was significantly increased. No difference in ocular torsion was observed with lateroflexion of the head to the ipsilateral side in comparison with lateroflexion to the contralateral side. Moreover, the overall ocular counterrolling was well within normal limits. We conclude that the semicircular canal response differs from the otolith response. The component of the torsional VOR mediated by otolith stimulation appears to be more robust than the horizontal VOR mediated mainly by the horizontal semicircular canal system. Ocular counterrolling induced by lateroflexion does not reveal abnormalities in patients with surgically produced unilateral peripheral loss.