Study of Early Eye and Head Movement Rehabilitation After Surgical Vestibular Nerve Removal for Vestibular Schwannoma

What this Trial Is About

The vestibulo-ocular reflex VOR helps maintain stable vision during head movements by causing the eyes to move in compensation. This reflex originates from the peripheral vestibular system and is especially important for rapid head movements, as assessed by the Head Impulse Test HIT. In cases of acute unilateral vestibular deficit AUVD, a compensatory eye movement called a catch-up saccade helps refocus vision. This study evaluates how early physiotherapy using the HIT might promote the learning and development of these catch-up saccades to improve recovery after vestibular damage, specifically after surgery to remove vestibular schwannomas, which cause a sudden and known vestibular deficit. Participants are randomly assigned to one of two groups an experimental group that performs gaze stabilization exercises with head movements under video HIT control, and a control group that performs eye movement exercises without head movements sham treatment. These exercises occur daily from the first to the sixth day after surgery. The experimental treatment involves fast, small head movements to stimulate the VOR, while the sham treatment involves visually guided eye movements without moving the head. Both treatments are supervised and use a device to monitor eye and head movements. During the study, participants will undergo various assessments including measurement of the first substitution saccade latency at several time points after surgery, balance and gait evaluations, and quality of life questionnaires before surgery and during follow-up visits at 7 days, 45 days, and three months post-surgery. The study also tracks saccade amplitude and latency daily during the first week after surgery. These evaluations help researchers understand how early rehabilitation affects recovery and visual function after acute vestibular deficit caused by surgery.

Early Rehabilitation Using Head Impulse Test for Acute Vestibular Deficit