Long-Term Balance Outcomes in Vestibular Ablative Surgeries

Area of Science:

• Otolaryngology
• Neurology
• Vestibular System Research

Background:

• Ménière's disease significantly impacts quality of life.
• Surgical interventions like vestibular nerve section (VNS) and labyrinthectomy (L) aim to alleviate symptoms.
• Long-term balance outcomes following these procedures require thorough evaluation.

Purpose of the Study:

• To compare the long-term balance outcomes of VNS and L surgeries.
• To analyze correlations between objective (computerized posturography - CP) and subjective (Dizziness Handicap Inventory - DHI) measures.
• To assess anterior-posterior versus medial-lateral balance performance post-surgery.

Main Methods:

• Retrospective analysis of 55 patients (31 VNS, 24 L) with Ménière's disease.
• Objective assessment using computerized posturography (CP) for anterior-posterior and medial-lateral balance.
• Subjective assessment via the Dizziness Handicap Inventory (DHI).

Main Results:

• VNS group showed significantly better anterior-posterior CP scores compared to the L group.
• Medial-lateral balance was more affected than anterior-posterior balance across all patients.
• No significant difference in DHI scores between VNS and L groups, nor correlation between CP and DHI.

Conclusions:

• Vestibular nerve section (VNS) offers superior long-term objective balance outcomes compared to labyrinthectomy (L).
• Unilateral ablative surgeries disproportionately affect medial-lateral balance more than anterior-posterior balance.
• Subjective balance perception (DHI) does not differ between surgical groups and does not correlate with objective balance tests.