Acoustic neuroma neurophysiologic correlates: vestibular-preoperative, intraoperative, and postoperative.

By the nature of their origin, acoustic neuromas always result in some degree of vestibular dysfunction. The implications of this are typically more notable postoperatively, rather than preoperatively or intraoperatively. However, preoperative vestibular assessment can have implications on operative approach and postoperative rehabilitation. This paper details the preoperative vestibular findings that correlate with differing stages of acoustic neuroma growth. It also describes the findings that help localize the tumor origin to either the inferior or superior divisions of the vestibular nerve. Finally, and probably most importantly, we discuss the causes of persistent postoperative vestibular symptoms.