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

Otol Neurotol. 2020 Dec;41(10):1427-1432. doi: 10.1097/MAO.0000000000002842.

Abstract

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.

MeSH terms

  • Adult
  • Dizziness / diagnosis
  • Dizziness / etiology
  • Humans
  • Neuroma, Acoustic* / surgery
  • Postural Balance
  • Retrospective Studies
  • Vertigo
  • Vestibular Function Tests
  • Vestibule, Labyrinth*