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Visual sensorial preference delays balance control compensation after vestibular schwannoma surgery
  1. C Parietti-Winkler (c.parietti{at}chu-nancy.fr)
  1. Inserm ERI 11 [EP]²R, France
    1. G C Gauchard (gerome.gauchard{at}nancy.inserm.fr)
    1. Inserm ERI 11 [EP]²R, France
      1. C Simon (c.simon{at}chu-nancy.fr)
      1. University Hospital of Nancy, France
        1. Ph P Perrin (philippe.perrin{at}staps.uhp-nancy.fr)
        1. Nancy-University, University Henri Poincaré, Nancy 1, France

          Abstract

          Background: Balance control performance after vestibular schwannoma surgical removal follows a course characterised by a deterioration in postural performance immediately after unilateral vestibular deafferentation (uVD) and a recovery process (vestibular compensation). However, sensory strategies for balance vary during tumoral growth, which could lead to differences in the preferential use of sensory afferences. This longitudinal study aimed to assess the post-operative sensorimotor strategies of postural regulation according to sensory preference of balance control before surgery.

          Methods: Twenty-two patients with vestibular schwannoma (11 relying less on vision (G1), 11 relying more on vision (G2), to control balance before surgery), underwent vestibular, subjective visual vertical (SVV), static posturography and sensory organisation (SOT) tests, before and eight days, one and three months after surgery.

          Results: In G1 patients, little static posturographic and SOT performance deterioration after uVD was observed, despite vestibular test and SVV modifications. In G2 patients, uVD-related modifications followed a time-course characterised by a degradation in posturographic and SOT, vestibular and SVV performances immediately after uVD and a progressive restoration and even improvement one month and particularly three months after surgery.

          Conclusions: High preference for vision before surgery intervenes in postural degradation immediately after surgery, thus delaying short-term effects of vestibular compensation on postural control. Long-term performance being similar whatever the visual status before surgery, the time-dependent implementation of the central adaptive mechanisms due to neuroplasticity leads to a modification of neurosensory information hierarchy, allowing thus to rely on appropriate information, the gain varying according to the postural task to be performed.

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