2025 Volume 84 Issue 2 Pages 42-50
[Purpose] There have been no reports of vestibular rehabilitation (VR) for the symptom of dizziness developing after temporal bone fracture. We report the case of a patient who presented with disequilibrium after temporal bone fracture, in whom we performed a detailed assessment of the vestibular function and VR. [Methods] The patient was a male in his 30s with left temporal bone fracture, who complained of still experiencing episodic vertigo while walking. VR and vestibular function assessment were conducted once a week for five weeks starting from the 22nd day after injury. The evaluated parameters included the subjective visual vertical (SVV), average vestibulo-ocular reflex gain in the lateral plane in the video Head Impulse Test (vHIT), average latency of catch-up saccades (CUS), score on the visual analogue scale (VAS) for dizziness sensation in the Head Shaking Nystagmus Test, the mean left-right position of the center of pressure during the Romberg test with the eyes closed for 60 seconds, the 95% confidence ellipse area, and the mean velocity of sway. [Results] Comparison of the results of testing conducted on days 22 and 57 revealed an increase of the left gain on the vHIT from 0.37 to 0.55 and decrease of the CUS. The SVV shifted from left bias to neutral. Although right horizontal nystagmus persisted in the Head Shaking Nystagmus Test, the score on the VAS decreased. In the Romberg test, the mean position shifted from left bias to right bias, and the 95% confidence ellipse area and mean velocity decreased. [Discussion] Despite the remaining decrease in gain in the vHIT, improved compensatory function through VR and habituation likely led to the subjective improvement of dizziness in the patient.
