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Is Gamma Knife Surgery effective for intracanalicular vestibular schwannomas?
Vestibular schwannomas (VSs) are rare, occurring in approximately five per 100,000 adults a year. In circa 8% of cases, the VS is contained within the internal auditory canal, i.e. intracanalicular (iVS). Although radiosurgery is a recognised treatment modality for VSs,...
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...
Does vestibular rehabilitation help patients with vestibular migraine? Is this also true if these patients have had a traumatic brain injury?
Vestibular migraine (VM) is a common diagnosis in ENT, and there is growing evidence that vestibular rehabilitation therapy (VRT) is an effective treatment, reducing self-perceived dizziness and improving gait. This is a retrospective review of the outcomes of 93 patients...
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...
Vestibular function preservation after minimally invasive paediatric cochlear implantation
This retrospective study analysed results in 24 paediatric patients with low-frequency residual hearing before and after minimally invasive cochlear implantation. The authors define minimally invasive cochlear implantation as a round window insertion of flexible Nucleus CI422, Nucleus CI522, MedEl Flex...
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...
Booklet-based supervised vs. non-supervised vestibular rehabilitation
There are conflicting results in the literature about home-based vestibular rehabilitation training (VRT) as opposed to physiotherapist-led training. A randomised controlled trial was designed to interrogate this further. The primary aim was to assess “the effects of a booklet-based exercise...
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...
