Multiple Labyrinthine-vascular Otic Capsule Dehiscence Treated by Endovascular Approach.

Objective:To explore the correlation between the parameters of video head impulse test （vHIT）and dizziness handicap inventory （DHI） score in patients with vestibular neuritis. Methods:Clinical data of 46 patients with vestibular neuritis were retrospectively analyzed. All the patients underwent DHI evaluation and vHIT examination. They were divided into mild handicap group, moderate handicap group and severe handicap group according to DHI score. The correlations between the parameters of vHIT and DHI score were compared among the three groups. The important parameters of vHIT were compared including vestibulo-ocular reflex （VOR） gain, gain asymmetry ratio （GA）, abnormal saccade dispersion （PR%）. Results:Of the 46 patients, 10 were in the mild handicap group, 21 in the moderate handicap group, and 15 in the severe handicap group. ①In the comparison of the mean value of lateral semicircular canal VOR gain, the vHIT gain of patients with mild, moderate and severe handicap were 0.64±0.06, 0.53±0.11 and 0.37±0.10, respectively, the mean value of VOR gain was negatively correlated with DHI score among the three groups（r=-0.545, P<0.001）, and the pairwise comparisons among the three groups was statistically significant（P<0.05）. In comparison of the mean values of lateral semicircular canal GA, the GA values of mild, moderate and severe handicap groups were 46.40±21.81, 47.59±15.17 and 56.57±17.39, respectively, there was no significant linear correlation between GA values and DHI scores among the three groups（r=0.246, P>0.05）, there was no significant difference between the three groups（P>0.05）. In comparison of the mean PR% of the lateral semicircular canal, the mean PR% of patients with mild, moderate and severe handicap group were 32.00±10.62, 53.82±17.09 and 76.00±10.01, respectively, PR% was positively correlated with DHI score（r=0.726, P<0.001）, and the comparison among the three groups was statistically significant（P<0.05）. ②The vertical semicircular canal vHIT gain of patients with mild, moderate and severe handicap was 0.63±0.06, 0.52±0.15 and 0.38±0.16, respectively, the mean of VOR gain was negatively correlated with DHI score among the three groups（r=-0.487, P<0.01）, the comparison of mild-severe and moderate-severe group was statistically significant（P<0.05）, while there was no significant difference between the mild and moderate group（P>0.05）. In the comparison of the mean values of vertical semicircular canal GA, the GA values of mild, moderate and severe handicap groups were 40.40±15.31, 46.10±19.59 and 47.87±18.05, respectively, there was no significant linear correlation between GA values and DHI scores among the three groups（r=0.047, P>0.05）, there was no significant difference in GA among the three groups（P>0.05）. The PR% of patients with mild, moderate and severe handicap were 42.40±15.39, 54.14±17.60 and 64.93±10.95, respectively, there was a positive significant correlation between PR% and DHI score（r=0.454, P<0.05）, there was statistically significant in the comparison of mild-severe group（P<0.05）, while there was no statistical significance between the other groups（P>0.05）. Conclusion:The VOR gain and PR% value of vHIT in patients with vestibular neuritis are closely related to the DHI score, which can evaluate the vestibular function and the degree of vertigo.

To compare dizziness handicap inventory (DHI) scores before and after surgery for plugging of superior canal dehiscence (SCD). The size of the dehiscence as measured during surgery, subject age, vestibular-evoked myogenic potentials threshold, and degree of conductive hearing loss (CHL) were also considered. Retrospective. Nineteen adults with SCD who underwent surgery to plug the SCD via middle fossa approach were studied. Pre- and postoperative DHI scores were compared, and correlations between DHI scores and other clinical measures were assessed. Average preoperative DHI score was 44 +/- 24 (mean +/- SD). Postoperative DHI score was significantly lower at 18 +/- 15 (P < .01). Only two subjects had a higher DHI score after surgery. Subjects who had a preoperative DHI score below 30 did not have any significant change in their DHI score after surgery, whereas those with a preoperative DHI score >or=30 had an improvement by an average of 39 +/- 16 after surgery. There were no correlations between either preoperative DHI score or the change in DHI score after surgery and HL, age, vestibular-evoked myogenic potentials threshold, or dehiscence size. DHI scores significantly decreased after SCD plugging. Subjects who had the largest decrease in DHI scores were those with high preoperative DHI scores. Subjects who chose to undergo SCD plugging because of nonvestibular symptoms such as conductive HL, tinnitus, or autophony generally had lower preoperative DHI scores and did not experience large improvements in DHI scores. The SCD plugging procedure offers an improvement in DHI score that is comparable with that of other procedures for peripheral vestibular dysfunction.

Objective: Evaluate the inner ear effects of canal wall down (CWD) mastoidectomy in the treatment of chronic otitis media (COM) in regard to bone conduction hearing and reported tinnitus and dizziness related disability. Method: Prospective study of 86 consecutive patients treated by CWD mastoidectomy for COM with or without cholesteatoma. Patients underwent preoperative audiogram and completion of 2 surveys: Dizziness Handicap Inventory (DHI) and Tinnitus Handicap Inventory (THI), which were repeated 4 to 6 months postoperatively. Results: No significant change in bone-conduction hearing scores occurred postoperatively. DHI and THI scores improved in the vast majority of patients. Thirteen patients, 13 out of 34 (38%), had DHI improvement greater than 18 points, indicating a significant patient-perceived improvement in dizziness-related disability. Sixteen patients, 16 out of 43 (37%), had THI improvement greater than 20 points, indicating a significant patient-perceived improvement in tinnitus-related disability. Three patients developed new-onset postoperative dizziness, and 5 patients developed new-onset postoperative tinnitus. The odds ratio for improving DHI and THI scores relative to or worsening scores is 6.6 in DHI (95% CI: 1.8 to 25.0) and 4.2 in THI (95% CI: 1.45 to 12.2). Conclusion: Canal wall down mastoidectomy did not result in new-onset sensorineural hearing loss. In addition, using the Dizziness Handicap Inventory and Tinnitus Handicap Inventory measures, patient-perceived disability from dizziness and tinnitus was shown to decrease after mastoid surgery.

To compare the therapeutic effect of electro-nape-acupuncture (ENA) combined with hyperbaric oxygen therapy (HBOT) and single HBOT on refractory flat descending idiopathic sudden sensorineural hearing loss (ISSNHL). A total of 78 patients were randomized into an ENA combined with HBOT (ENA+HBOT) group and a HBOT group, 39 cases in each one. Patients in both groups were treated with oral extract of ginkgo biloba leaves and mecobalamin tablets. On the basis of the conventional medication treatment, HBOT was adopt in the HBOT group. On the basis of the treatment in the HBOT group, electro-nape-acupuncture was applied at Fengchi (GB 20), Gongxue (Extra), Zhongzhu (TE 3), Waiguan (TE 5) and Yifeng (TE 17), Tinggong (SI 19), Tinghui (GB 2) and the vertigo-auditory area of affected side in the ENA+HBOT group. Pulse acupuncture instrument was connected at Fengchi (GB 20) and Gongxue (Extra) for 30 min (with continuous wave, 2 Hz in frequency), the needles were retained for another 30 min after electroaupuncture. The treatment was given once a day, 6 times a week for 4 weeks in both groups. Before the treatment and 2,4 weeks into the treatment, the average auditory threshold, the scores of tinnitus handicap inventory (THI) and dizziness handicap inventory (DHI) were observed, and the therapeutic effect was evaluated in both groups. Compared before treatment, the average auditory threshold, the scores of THI and DHI of 2,4 weeks into the treatment were decreased in both groups (P<0.000 1). Compared with the HBOT group, the average auditory threshold, the scores of THI and DHI of 4 weeks into the treatment were lower in the ENA+HBOT group (P<0.000 1). The total effective rate was 69.2% (27/39) in the ENA+HBOT group and 51.3% (20/39) in the HBOT group, there was no statistical difference (P>0.05). Electro-nape- acupuncture can improve the mean auditory threshold and the symptoms of tinnitus and dizziness in patients with refractory flat descending idiopathic sudden sensorineural hearing loss.

Long-Term Quality of Life and Audiometric Outcomes Following Noninvasive Stereotactic Radiosurgery for Acoustic Neuromas

Background and Aim: Evaluating the effective­ness of vestibular rehabilitation (VR) in patients with vestibular lesions has always been a challe­nge. The questionnaires that are used for this pur­pose mostly show the degree of vestibular dis­ability rather than providing information about improvement of vestibular dysfunction. This study aimed to evaluate whether video head imp­ulse test (vHIT) that is used for the examination of vestibulo-ocular reflex (VOR), is a useful method for predicting the effectiveness of VR and has a correlation with dizziness handicap inventory (DHI) score.&#x0D; Methods: Participants were 42 patients with unilateral peripheral vestibular hypofunction (UPVH) undergoing VR. Patients were assessed before and after rehabilitation by the vHIT in all ipsilesional and contralesional semicircular can­als (SCCs) and the DHI. The changes in DHI score and VOR gain before and after rehabili­tation, were shown as ΔDHI and ΔVOR and their correlation was evaluated.&#x0D; Results: VOR gain from ipsilesional and contra­lesional SCCs was improved significantly after VR. There was a significant strong negative correlation between ΔVOR gain from ipsile­sional SCCs and ΔDHI score but no significant correlation was found between the ΔDHI score and ΔVOR gain from contralesional SCCs.&#x0D; Conclusion: vHIT test is a useful tool to evaluate the effectiveness of VR. VOR gain is correlated with the DHI score. Therefore, the improvement in vHIT results in all three SCCs after VR may be a good predictor of the degree of improvement in dizziness-related disability.&#x0D; Keywords: Vestibular rehabilitation; follow-up; unilateral vestibular hypofunction; video head impulse test; dizziness handicap inventory

To evaluate the inner ear effects of canal wall down (CWD) mastoidectomy without ossiculoplasty in the treatment of chronic otitis media (COM) with regard to sensorineural hearing loss (SNHL) and reported tinnitus and dizziness-related disability. Tertiary care academic medical center. Prospective study of 86 patients treated by CWD mastoidectomy without ossiculoplasty for COM with or without cholesteatoma. Standard patient workup included preoperative audiogram and completion of 2 surveys: Dizziness Handicap Inventory (DHI) and Tinnitus Handicap Inventory (THI). Patients underwent repeat audiogram, DHI, and THI surveys at 4 to 6 months postoperatively. Preoperative and postoperative data were analyzed. No significant SNHL occurred after CWD mastoidectomy. Thirteen patients (13/34 [38%]) had DHI improvement greater than 18 points, indicating a significant improvement in dizziness-related disability. Three patients developed new-onset postoperative dizziness complaints. Twenty patients (20/43 [46.5%]) had THI improvement greater than 7 points, indicating a significant improvement in tinnitus-related disability. Five patients developed new-onset postoperative tinnitus complaints. The odds ratio for improving DHI and THI scores after surgery was 6.6 (1.8 to 25.0) and 4.2 (95% confidence interval, 1.45% to 12.2%), respectively. In this study, CWD mastoidectomy without ossiculoplasty in the treatment of COM did not cause significant SNHL. In addition, using the DHI and THI measures, patient-perceived disability from dizziness and tinnitus, respectively, was shown to decrease after mastoid surgery.

Objective To explore the effect of psychological and behavioral intervention on quality of life (QOL) of Meniere' s disease (MD) patients.Methods Eighty-four MD inpatients(as observational group) and 80 healthy subjects undergoing physical examination (as control group)were enrolled into this study.The observational group was divided into intervention group (n=42) and non intervention group (n=42) randomly.Patients in the intervention group were given psychological and behavioral intervention both in hospital and out of hospital besides general nursing care and health guidance while patients in non-intervention group were only given general nursing care and health guidance.The QOL of them when they were in hospital and 3 months after discharging from the hospital were measured with Chinese version 36-item Short Form Heath Survey(SF-36) and the English Chinese version Dizziness Handicap Inventory(DHI).The differences between observational group and control group were compared.Results The scores of SF-36 in the observational group (492.58±98.76) were lower than that in the control group ( 688.46±115.48 ).while the scores of DHI in the observational group (89.84±28.13) were higher than that in the control group ( 8.57±4.59 ).Both of them have significantly statistical differences ( t=11.69,25.52 ; P＜0.05 ).After 3 months of discharging from the hospital,the scores of SF-36 in the intervention group (681.58±109.43) were higher than that in the non-intervention group (621.47±98.74),while the scores of DHI in the intervention group (9.08±5.22) were lower than that in the non-intervention group( 17.42±8.17 ).Both of them have significantly statistical differences ( t=2.64,5.58 ;P＜0.05 ).Both the scores of SF-36 and DHI have no significantly statistical differences between the intervention group (681.58±109.43) and (9.08±5.22) and the control group (688.46±115.48) and (8.57±4.59),respectively.Conclusions MD significantly influent the sufferers' QOL while psychological and behavioral intervention can significantly improve the MD patients' QOL. Key words: Meniere's disease; Psychological and behavioral intervention; Quality of life

Objective: To guide the patients with vertigo who are suitable for vestibular rehabilitation therapy (VRT), and to evaluate the curative effect through a remote guidance platform based on mobile internet. Methods: Adult outpatients, who were diagnosed as vestibular disorders and required VRT, were selected and conducted baseline evaluation and formulated vestibular rehabilitation plan according to their symptoms, diagnosis and vestibular function examination results. These patients downloaded and installed the mobile internet remote guidance platform app for VRT, and then registered and uploaded medical records. According to the VRT plan formulated by clinicians for patients, the platform launched corresponding exercise guidance videos to guide them to complete 4-week VRT exercise at home. Before and after VRT, the patients were scored with Visual Analogue Scale (VAS), Activities-specific Balance Confidence (ABC), Dizziness Handicap Inventory (DHI) and Self-rating Anxiety Scale (SAS). The rehabilitation effects were statistically analyzed by SigmaStat 4.0 software. Results: From October 2019 to October 2021, 233 patients with vertigo completed the registration of vestibular rehabilitation guidance platform, of whom 187 patients insisted on 4-week rehabilitation training and completed the scale evaluation. Among 187 patients, 65 were male and 122 were female; Age was (49.8±16.0) years; The medical history ranged from one to 192 months, with a median of eight months. Compared with that before rehabilitation exercise, the subjective feeling of vertigo in 170 patients was improved, and the overall effective rate was 90.9% (170/187). The subjective symptoms of vertigo were basically improved after rehabilitation training in patients with unilateral vestibular dysfunction, vestibular neuritis, sudden deafness with vertigo, Hunt syndrome and acoustic neuroma. There were significant differences in ABC, DHI and SAS scores before and after VRT (P<0.05). Of those patients with Meniere's disease in the intermittent period and the patients with Meniere's disease who underwent surgical treatment, more than 90% of their subjective symptoms of vertigo or dizziness improved after VRT, and there were significant differences in the scores of ABC, DHI and SAS before and after VRT exercise (P<0.05). In patients with vestibular migraine, 36.7% (11/30) had no improvement or even aggravation of subjective symptoms of vertigo after VRT, however, the DHI score after rehabilitation exercise was lower than that before exercise, and the difference was statistically significant (P<0.05). In patients with bilateral vestibular dysfunction, although most (6/8) subjective symptom scores were improved compared with those before exercise, there was no significant difference in ABC, DHI and SAS scores before and after rehabilitation (P>0.05). Conclusion: VRT with the help of vestibular rehabilitation mobile internet remote guidance platform can effectively improve the subjective symptoms of vertigo, balance ability and anxiety in patients with unilateral vestibular lesions.

Background and purposeVestibular migraine (VM) is a common clinical disorder with a genetic predisposition characterized by recurrent episodes of dizziness/vertigo. Patients often complain of the presence of cognitive dysfunction manifestations such as memory loss, which causes great distress in daily life. In this study, we will explore the characteristics and possible risk factors of VM-related cognitive dysfunction by observing the cognitive function and vestibular function status of VM patients, laying the foundation for further exploration of the mechanisms of VM-related cognitive dysfunction.MethodsThis study included 61 patients with VM and 30 healthy individuals matched for age, gender, and education level. All subjects underwent the Addenbrooke’s Cognitive Examination-Revised (ACE-R), Dizziness Handicap Inventory (DHI), Hospital Anxiety and Depression Scale (HADS), Patient Health Questionnaire-9 (PHQ-9), and Generalized Anxiety Disorder-7 (GAD-7) at the first time of enrollment. Based on the ACE-R scores, the VM group was divided into the VM with cognitive dysfunction (VM-CogD) group (ACE-R &amp;lt; 86) and the VM without cognitive dysfunction (VM-NoCogD) group (ACE-R ≥ 86). The VM-CogD group was further categorized based on DHI scores into mild, moderate, and severe dizziness/vertigo subgroups (DHI ≤ 30 for mild, 30 &amp;lt; DHI ≤ 60 as moderate, and DHI &amp;gt; 60 as severe). All subjects underwent the head-shaking test, head-impulse test, test of skew, Romberg test, Unterberger test, videonystagmography, and caloric test to evaluate their vestibular function including the semicircular canals, vestibulo-ocular reflex pathway, and vestibulo-spinal reflex pathway. Differential analysis, correlation analysis, and ROC curve analysis were used to analyze the characteristics and influencing factors of the above clinical indicators in VM patients. It was considered that p-value &amp;lt; 0.05 was statistically significant, and | r| &amp;gt; 0.3 indicated a good correlation.ResultsThere were no significant differences between the VM group and healthy control (HC) group in sex, age and education level. The total ACE-R score of the VM group was [82 (68.5, 87)], and the total ACE-R score, memory, verbal fluency, language, and visuospatial function scores were significantly lower than those of the HC group (p-value &amp;lt; 0.05) The percentage of horizontal semicircular canal dysfunction in the VM group (82.0%), the percentage the ocular motor dysfunction (49.2%), the positive percentage of the head-shaking test (27.9%), head-impulse test (37.7%), Romberg’s sign (60.7%), and Unterberger’s sign (60.7%) were significantly higher than those in the HC group (p-value &amp;lt; 0.05). Comparing the VM-CogD group (ACE-R &amp;lt; 86) with the VM-NoCogD group (ACE-R ≥ 86), the differences in Canal Paresis (CP) value, age, years of education, and duration of the disease were statistically significant (p-value &amp;lt; 0.05). In the VM-CogD group, CP value was negatively correlated with the ACE-R total score (r = 0.571, p-value = 0.000), memory (r = 0.526, p-value = 0.000), verbal fluency (r = 0.345, p-value = 0.024), language (r = 0.524, p-value = 0.000), and visuospatial function (r = 0.340, p-value = 0.026) scores. Age was negatively correlated with language functioning scores (r = 0.384, p-value = 0.011), and years of education was positively correlated with ACE-R total score (r = 0.504, p-value = 0.001) and language functioning (r = 0.455, p-value = 0.002) scores. When the cutoff values for the CP value, age, years of education, and duration of disease were 25.5, 33, 15.5, and 6.5, the accuracy of predicting VM-related cognitive dysfunction was the highest. The differences in DHI, DHI-P, DHI-E, DHI-F, HADS, PHQ-9, and GAD-7 scores were statistically significant between the VM group and the HC group (p-value &amp;lt; 0.05). In VM-CogD patients presenting with moderate dizziness/vertigo, the DHI total score was negatively correlated with the ACE-R total score (r = 0.539, p-value = 0.008), the DHI-F score was negatively correlated with the language (r = 0.450, p-value = 0.031) and visuospatial functioning part (r = 0.415, p-value = 0.049) scores, and the HADS-D scores were negatively correlated with the ACE-R total score and the part of memory functioning score (r = 0.539, p-value = 0.008).Conclusion(1) VM Patients exhibit multifaceted vestibular dysfunction and varying degrees of cognitive dysfunction, and cognitive function is affected by age, duration of illness, years of education, and vestibular function; (2) VM is a functional disorder, and the function disturbance, in conjunction with anxiety and depression, may participate in the occurrence of development of cognitive dysfunction in VM.

Objective: To assess the perception of disability in patients with presbyvestibulopathy and to determine the factors (demographic, balance test scores, and comorbidities) that determine higher levels of disability.Material and Methods: This was a cross-sectional study conducted in a tertiary university hospital. There were 103 patients who fulfilled the diagnostic criteria for presbyvestibulopathy and were included. Dizziness Handicap Inventory (DHI) score was the main variable used to quantify disability. Influence on DHI score, sex, age, time of evolution, equilibriometric parameters (posturographic scores and timed up and go test), history of falls, comorbidities (high blood pressure, diabetes, and dyslipidemia), psychotropic drug use, tobacco or alcohol use, living environment (urban or rural), and active lifestyle were analyzed.Results: Most of the DHI scores showed a moderate (46 patients, 44.7%) or severe (39 participants, 37.9%) handicap. DHI scores were higher in women (59.8 vs. 36.1, p < 0.001), patients with obesity (58.92 vs. 48.68; p = 0.019), benzodiazepine (59.9 vs. 49.1, p = 0.008) or other psychotropic drug (60.7 vs. 49.2, p = 0.017) users, and fallers (57.1 vs. 47.3, p = 0.048). There was also a significant positive correlation between DHI score, time (Rho coefficient: 0.371, p < 0.001), and steps (Rho coefficient: 0.284, p = 0.004) used in the TUG and with the short FES-I questionnaire (a shortened version of the Falls Efficacy Scale-International) score (Rho coefficient: 0.695, p < 0.001). DHI scores were lower in alcohol consumers than in non-drinkers (46.6 vs. 56, p = 0.048). No significant correlation was found between DHI scores and age, time of evolution, posturographic scores, comorbidities, environment (rural or urban), or active lifestyle.Conclusion: Most patients with presbyvestibulopathy show an important subjective perception of disability in relation to their symptoms. This perception is substantially higher in women than in men. The most influential factors are difficulties in walking, fear of falling, and obesity.Unique Identifier: NCT03034655, www.clinicaltrials.gov.

Background: Posterior canal benign paroxysmal positional vertigo (p-BPPV) is the most common peripheral vestibular problem. Many doctors use three treatment options for p-BPPV: drugs alone, Epley’s maneuver with drugs, and Epley’s maneuver alone. Many studies say that Epley’s maneuver with drugs improves the condition much more effectively than drugs alone. Our study is intended to assess the effectiveness of Epley’s maneuver alone in treating posterior canal BPPV. Methods: A prospective analytical study was performed on 102 patients who were divided into 2 groups after random sampling. Group I underwent repeated applications of Epley’s maneuver alone, and group II underwent a single Epley’s maneuver along with drugs. The data were collected systematically with the help of a proforma and dizziness handicap inventory (DHI) score chart. The patients were reviewed after 24 hours, 1 week, and 1 month. Results: In our study, the mean pre-treatment DHI score of group I was 66.71, and group II was 64.39. After 24 hours, the DHI score came down to 46 and 47.61 respectively, and after 1 week and 1 month, it decreased to 33.06 and 22.86, respectively in group I and group II, it came to 44.71 and 38.78, respectively. The difference in mean DHI score between groups I and II is statistically significant, with each review having a p value of 0.00. Conclusions: This study was able to demonstrate the efficacy of Epley's maneuver in the treatment of BPPV without any drug.

Objective:This study was designed to observe the dizziness handicap inventory (DHI) scores in patients with BPPV (benign paroxysmal positional vertigo) before and after maneuver repositioning and aimed to discuss the values of DHI scores in the diagnosing and treatment of BPPV. Method:Charts of 72 patients with BPPV diagnosed by positioning test were reviewed. Four DHI scores were used including the total score (DHIT), the functional score (DHIF), the emotional score (DHIE), and the physical score (DHIP). We compared the pre-repositioning DHI scores and post-repositioning scores of patients, and also compared the DHI scores of patients with and without residual dizziness. Result:All of the 72 patients were underwent maneuver repositioning and recorded the DHI scores. The mean post-repositioning scores were dramatically decreased compared with pre-repositioning scores, and the difference was significant (P<0.01). The differences of the DHIP scores between the residual dizziness group and the non-residual dizziness group was not significant, while the DHIF scores, the DHIE scores and the DHIT scores between the two groups were statistically different. Conclusion:After maneuver repositioning the dizziness handicap of BPPV patients could be significantly improved. The next treatment program for residual dizziness patients after successful repositioning could be aimed at the functional and emotional dizziness.

Evaluate and compare the Dizziness Handicap Inventory with Activities-specific Balance Confidence scores shortly after vestibular schwannoma excision. Retrospective database review. Tertiary care center. Adults undergoing vestibular schwannoma excision between January 2015 and December 2019. Diagnostic, therapeutic, and rehabilitative. 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. 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). 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.

To determine the degree to which electrocochleography (ECoG) correlates with auditory and vestibular outcomes after repair of superior semicircular canal dehiscence (SSCD) via transmastoid (TM) and middle cranial fossa (MCF) approaches. Retrospective review. Academic tertiary referral center. Adults with SSCD who underwent repair between 2005 and 2019. Pre-, intra-, and postoperative ECoG. Patient-reported vestibular and auditory symptoms; pre-, intra-, and postoperative ECoG measures, dizziness handicap inventory (DHI) scores. Forty-six patients underwent SSCD repair (40 unilateral, six bilateral) between 2005 and 2019, including 24 MCF and 28 TM approaches. There were no differences in preoperative, intraoperative, or postrepair ECoG SP/AP values between the MCF and TM groups (p 0.12, 0.77, 0.58). Patients had subjective improvement in vestibular symptoms (or stable vestibular function in patients operated for predominantly auditory manifestations) with both approaches (MCF: 87.5%; TM: 92.3%; p 0.64). A successful outcome correlated with intraoperative SP/AP ratio normalization (p 0.0005). Similarly, DHI scores were similar in both groups preoperatively (p 0.66) and returned to their preoperative baseline postoperatively with both (p 0.52). Reported vestibular symptoms persisted or worsened more often in patients with migraine (66.6% vs. 28.9%, p 0.03), and with persistently abnormal ECoG measures, though the latter was not statistically significant in this population (38% vs. 15%, p 0.10). Patients had subjective improvement or stability in auditory symptoms using either approach (MCF: 96%; TM: 100%; p 0.62), also correlating with SP/AP ratio normalization (p 0.008). Correction of abnormal preoperative ECoG reliably correlates to patient symptom improvement after SSCD repair. No significant differences in postoperative outcomes were noted between patients undergoing TM versus MCF repair. Circumspection regarding the likelihood of an ideal outcome after SSCD repair should be exercised when counseling patients with concomitant migraine. It is not certain whether outcomes differ between the two dominant approaches for SSCD repair. Surgeons and patients would benefit from an intraoperative metric that reflects satisfactory plugging of SSCD. To highlight the reliability and unique utility of intraoperative ECoG and demonstrate the correlation between ECoG correction and symptom improvement for SSCD repair. To report subjective and objective outcomes following SSCD repair and encourage adoption of intraoperative ECoG monitoring. Level V. IRB review considers this study exempt (HUM00169949).