Objectives To assess whether vestibular prehabilitation with intratympanic gentamicin is a useful preoperative adjunct in allowing for early mobilization and short length of stay in patients with vestibular schwannoma (VS).

Design Retrospective single-center study and literature review.

Setting Tertiary neurosurgical center.

Participants Adult patients undergoing surgery for VS.

Main Outcome Measures Our primary outcome measures were evidence of compensation following prehabilitation (defined as saccades becoming more covert and clustered on video head impulse testing—vHIT), length of stay, and days until mobilization. Secondary outcome measures were reduction in gain on vHIT following treatment as well as need for antiemetics postoperatively.

Results Ten patients have been treated at our center and the majority have shown preoperative reduction in gain and evidence of compensation on vHIT. Median time to mobilization was 1 day and modal length of stay was 6 days. We found the current evidence to be variable, with small sample sizes and significant variation in outcome measures used.

Conclusion Overall we have found that the use of vestibular prehabilitation enables early mobilization, shortened length of stay and appears to be a promising preoperative adjunct in this population. Further research and assessment with a multicenter prospective clinical trial is merited.

目的 评估鼓室内庆大霉素进行前庭预康复是否是一种有用的术前辅助手段，有助于前庭神经鞘瘤 (VS) 患者早期活动和缩短住院时间。

设计 回顾性单中心研究和文献综述。

设置 三级神经外科中心。

参与者 接受 VS 手术的成年患者。

主要结果指标 我们的主要结果指标是预康复后的补偿证据（定义为眼跳变得更加隐蔽并集中在视频头部脉冲测试 - vHIT）、住院时间和距离活动前的天数。次要结果指标是治疗后 vHIT 增益的减少以及术后止吐药的需要。

结果 10 名患者已在我们​​中心接受治疗，其中大多数患者表现出术前增益减少以及 vHIT 代偿的证据。中位活动时间为 1 天，最常住院时间为 6 天。我们发现当前的证据是可变的，样本量较小，并且所使用的结果指标存在显着差异。

结论 总的来说，我们发现前庭预康复的使用可以实现早期活动，缩短住院时间，并且似乎是该人群中一种有前途的术前辅助手段。值得进行多中心前瞻性临床试验的进一步研究和评估。