Predictors of central vestibular compensation after surgery for vestibular schwannomas

Surgical removal of vestibular schwannoma causes acute vestibular symptoms, including postoperative vertigo which is the most negative factor affecting quality of life in patients after vestibular schwannoma surgery. The main aim of this study is to determine whether the results from routine electronystagmography with pathological visually-provoked responses can predict poor postoperative compensation. We also investigate whether postoperative central compensation is related to objective parameters such age, tumour size, length of surgery and persistent nystagmus. According to the results from preoperative electronystagmography, patients were divided into three groups: peripheral, central and combined vestibular syndrome. Signs of central compensation were evaluated by the presence of postoperative nystagmus, vertigo, deviation of subjective visual vertical and head impulse test. There were no statistically significant differences between groups in observed signs of compensation. These results suggest that pathological central oculomotor parameters are not a negative predictive factor for central vestibular compensation.