| Item type: | Article | ||||||||||||||||||||||||||||||||||||||||||||||||
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| Journal or Publication Title: | Clinical neurology and neurosurgery | ||||||||||||||||||||||||||||||||||||||||||||||||
| Publisher: | ELSEVIER SCIENCE BV | ||||||||||||||||||||||||||||||||||||||||||||||||
| Place of Publication: | AMSTERDAM | ||||||||||||||||||||||||||||||||||||||||||||||||
| Volume: | 113 | ||||||||||||||||||||||||||||||||||||||||||||||||
| Number of Issue or Book Chapter: | 1 | ||||||||||||||||||||||||||||||||||||||||||||||||
| Page Range: | pp. 52-56 | ||||||||||||||||||||||||||||||||||||||||||||||||
| Date: | January 2011 | ||||||||||||||||||||||||||||||||||||||||||||||||
| Institutions: | Medicine > Lehrstuhl für Neurochirurgie | ||||||||||||||||||||||||||||||||||||||||||||||||
| Identification Number: |
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| Classification: |
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| Keywords: | QUALITY-OF-LIFE; ACOUSTIC NEUROMA RESECTION; FACIAL-NERVE FUNCTION; HEARING PRESERVATION; SURGICAL-MANAGEMENT; SURGERY; REMOVAL; NAUSEA; DYSEQUILIBRIUM; COMPLICATIONS; Risk factors; Dizziness; Nausea; Severe symptoms; Vestibular schwannoma | ||||||||||||||||||||||||||||||||||||||||||||||||
| Dewey Decimal Classification: | 600 Technology > 610 Medical sciences Medicine | ||||||||||||||||||||||||||||||||||||||||||||||||
| Status: | Published | ||||||||||||||||||||||||||||||||||||||||||||||||
| Refereed: | Yes, this version has been refereed | ||||||||||||||||||||||||||||||||||||||||||||||||
| Created at the University of Regensburg: | Unknown | ||||||||||||||||||||||||||||||||||||||||||||||||
| Item ID: | 29179 |
Web of ScienceAbstract
Objective: Dizziness, a common postoperative symptom in patients with vestibular schwannomas (VSs) has a negative effect on the course of recovery, particularly in patients with severe symptoms. Reports on incidence and possible risk factors contributing to these symptoms are inconsistent and sometimes even contradictory. In order to establish a profile of patients at risk of severe symptoms in ...
Abstract
Objective: Dizziness, a common postoperative symptom in patients with vestibular schwannomas (VSs) has a negative effect on the course of recovery, particularly in patients with severe symptoms. Reports on incidence and possible risk factors contributing to these symptoms are inconsistent and sometimes even contradictory. In order to establish a profile of patients at risk of severe symptoms in the immediate postoperative phase we retrospectively analyzed data of patients with unilateral VSs focusing on the incidence of severe dizziness and nausea during the immediate postoperative period and up to 1 year after surgery. Methods: In a retrospective study data of 104 consecutive patients with VSs were analyzed. All patients underwent microsurgical tumor resection via a lateral-suboccipital approach. Factors that were assumed to affect the development of severe dizziness, such as age, gender, tumor size, tumor side, and cranial nerve function, were analyzed by means of univariate and multivariate logistic regression analyses. A three step grading system was used to describe symptoms of patients included in this study: 0 = no symptoms of dizziness, I = slight dizziness including light-headedness or feeling of disequilibrium and 2 = severe dizziness with nausea including imbalance or insecurity when walking, requiring antiemetic treatment. Results: Data of 92 patients, 41 men and 51 women, were available for analyses. Mean age of treated patients was 53 years (range 17-81). There was no predilection of side (52.2% right/47.8% left). Before surgery 39 patients (42.4%) were symptom free (grade 0), 13 patients (14.1%) had slight symptoms (grade 1) and 40 patients (43.5%) suffered from severe symptoms (grade 2). Immediately after surgery two patients (2.2%) where symptom free (grade 0), 19 patients (20.7%) had slight symptoms (grade 1) and 71 patients (77.2%) suffered from severe symptoms (grade 2). All patients with grade 2 symptoms required antiemetic treatment ranging between 1 and 10 days (mean 4 days). Logistic regression analyses showed young age, large tumor size (T3/T4), female gender, and severe preoperative symptoms to be main factors increasing the odds for patients to develop severe symptoms postoperatively. Conclusion: Patients at risk to develop severe symptoms should receive antiemetic treatment even before surgery. If in doubt about the actual risk for a specific patient with a large tumor (T3 or T4) available data suggests that patients will benefit if antiemetic treatment is started early, even before surgery. (C) 2010 Elsevier B.V. All rights reserved.
Metadata last modified: 29 Sep 2021 07:39
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