Postoperative Vestibular Dysfunction Following Head and Neck Surgery

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Abstract
Patients scheduled for major oncologic head and neck surgery underwent preoperative audiometry and rotational testing for vestibulo-ocular response (VOR). Patients with normal preoperative VOR and SRT less than 45 dB were subsequently retested following surgery for VOR. Patients deemed abnormal on postoperative rotational testing were retested until VOR returned to normal or one year, whichever came first. Eighty patients had normal VOR measured preoperatively. At the first postoperative testing 46 of these patients (58%) were determined to have significant VOR abnormalities. No differences in length of anesthesia, use of hypnotic or narcotic drugs, hepatic and renal abnormalities, and dehydration were noted in the patients who developed abnormal VOR, when compared to the patients who maintained normal VOR. One year post surgery twenty patients (43%) continued to demonstrate vestibular abnormality. The observation that major surgery reduces vestibular response has important monitoring and treatment implications. The integration of this data with the results of endolymphatic surgery are discussed.