Acoustic neuroma: postoperative vertigo and the mechanisms of compensation

Ninety-five percent of patients with acoustic neuroma experience some degree of vertigo preoperatively, postoperatively or both. Postoperative vertigo is often a debilitating condition that results when the eighth cranial nerve is severed during surgery to resect a tumor growing around the vestibular portion of this nerve. Thus, surgery for acoustic neuroma affects the membranous labyrinth, which is the functional part of the vestibular apparatus and is primarily concerned with equilibrium. Compensation for impaired equilibrium may be by biofeedback in the vestibular pathways, visual control, exercise or drug therapy. Nurses can significantly influence the recovery of acoustic neuroma patients by encouraging and reinforcing exercise and other mechanisms of vestibular compensation.