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688 results found

Delayed facial palsy post vestibular schwannoma resection

This article presents findings of a retrospective evaluation of 489 patients who underwent vestibular schwannoma surgery and developed delayed facial palsy. The authors define delayed facial palsy as deterioration of at least two HB grades between postoperative days five and...

Drug side-effects on audiological and vestibular testing

Are they a malingerer? Or perhaps they are inattentive? It may be their drugs! Robert DiSogra considers the side-effects of medication on the test subject. The audiogram serves many purposes in clinical practice. For the audiologist, it helps to differentiate...

Hearing rehabilitation after vestibular schwannoma surgery

Hearing rehabilitation is a key focus of the management of patients with vestibular schwannoma. But how do we rehabilitate hearing when the cochlear nerve has been damaged by tumour, irradiation, or resective surgery? Mathieu Trudel, Scott Rutherford and Simon Lloyd...

Using psychological behaviour change theory in vestibular practice

Fiona Barker explains the importance of recognising and understanding how habitual behaviours in vestibular patients can affect treatment outcomes, and how we as audiologists can support and encourage patients to modify these behaviours and perhaps address our own professional behaviours...

The applicability and reliability of SHIMP, a new vestibular test, in adolescents

The video head impulse (now called the head impulse paradigm – HIMP) is now a routine test battery in neuro-otological practice. Few will be familiar with the new suppression head impulse paradigm (SHIMP) test. The key difference is that, in...

Extrapolating lessons from vestibular schwannoma management

This paper presents a delightfully simple and sensible hypothesis for the management of benign schwannomas in the head and neck region. They have taken the approach used for the management of vestibular schwannomas and used the same principles to assess...

Vestibular migraine – the story so far and the work still to do

This interesting discussion paper begins with an overview of the background to the development of vestibular migraine as a separate diagnostic category. It discusses in some depth the diagnostic uncertainties in the context of an entity without a biomarker and...

How can we improve outcomes for patients with acute vestibular neuritis?

Vestibular neuritis is a common disorder that can leave up to 50% of patients with persistent vertigo symptoms for months to years following the acute insult. Often their first contact with ENT or balance specialists is many months after the...

Using cVEMPs to distinguish between vestibular migraine and from Ménière’s

Vestibular migraine (VM) and Ménière’s disease (MD) could overlap or mimic each other. Since the use of cVEMPs became routine, attempts have been made by researchers to explore its clinical utility in these two conditions. In this prospective study, the...

Outcomes after facial nerve preservation surgery for large vestibular schwannomas

Large vestibular schwannomas (Koos grade three or four) are traditionally treated by surgical resection. Gross total resection of such large tumours often results in facial nerve dysfunction. Hence facial nerve preservation surgery was introduced in which maximal surgical resection is...

Hearing outcomes after retrosigmoid resection of smaller vestibular schwannomas are better

The authors reviewed published literature reporting hearing outcomes in patients after retrosigmoid (RS) resection of vestibular schwannoma (VS). Aggregate hearing preservation of 31% and 35% under fixed and random models respectively was observed in the 2034 patients meeting eligibility criteria...

A raised neutrophil / lymphocyte ratio predicts vestibular schwannoma growth

It has long been known that the neutrophil to lymphocyte count ratio (NLR) is a marker of inflammation and that a higher ratio relates to poorer outcomes in some malignant tumours including some head and neck cancers. Neutrophilia (and therefore...