Research Information System
Thesis Type: Expertise In Medicine
Institution Of The Thesis: Gazi Üniversitesi, Tıp Fakültesi, Turkey
Approval Date: 2017
Student: FAKİH CİHAT ERAVCI
Supervisor: METİN YILMAZ
Abstract:Objective: to evaluate the effects of vestibular neurectomy and total labyrinthectomy surgical interventions on vestibulo-ocular reflex (VOR) and central compensation with objective and subjective tests. As a secondary output, it is aimed to determine whether there are parameters which can be used in addition to VOR gain in Video Head Impulse Test (VHIT) in vestibular deafference cases. It is also contemplated to share our clinical experience with the literature. Materiels and Methods: 19 vestibular neurectomy and 18 total labyrinthectomy patients who had undergone previous operations in our clinic and who had past at least one year after the operation were included in the study. Prospectively, VHIT and Computurized Dynamic Posturography (CDP) objective tests were administered to these patients. Dizziness Handicap Inventory (DHI) and Visual Analogue Scale (VAS) scoring were also applied as subjective dizziness test. Results: VOR gain results were found to be compatible between the two groups. There was a significant difference between the operation side and the opposite side of the operation. There was a weak positive correlation between the VOR gain on the opere side and the CDP medial-lateral vestibular data. On the operation side, especially in the lateral canal, the covert saccade presence reached to 89% and the overt saccade presence reached to 100%. There was a significant difference between the saccade presence on the operation side and the opposite side of the operation. It was also found that, on the side of the operation side, whether or not the saccades form organization pattern caused a slight significant differentiation in DHI. An increase in the amplitudes of the saccades showed a weak negative correlation between the CDP vestibular data. It was statistically significant that the medial-lateral data of CDP were more affected than the anterior-posterior data in both operation groups. In addition, although vestibular neurotomy group had lower somatosensory scoring data in CDP, vestibular scoring data were found to be higher. DHI data were also found to be better in the neurectomy group. In terms of preoperative dizziness, the visual analog scale (VAS) score of the Meniere group was found to be higher than the labyrinth destroying cholesteatoma group. Conclusion: In assessing the results of the VHIT test, addition to VOR gain, the presence of saccades, latency and amplitude data provide additional information. These data are thought to be better reflected especially in the lateral canal results. In vestibular deafferation operations, medial-lateral vestibular results are more affected than anterior-posterior vestibular results. In addition, the vestibular scores and DHI scores are better in vestibular neuroctomy group than the total labyrinthectomy group.