Can Dizziness Handicap Inventory and Activities-Specific Balance Confidence Scores Assess Vestibular Loss After Vestibular Schwannoma Excision?. Issue 10 (December 2020) - Erbele, Isaac D.
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.