{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T13:21:17Z","timestamp":1780406477351,"version":"3.54.1"},"reference-count":24,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2023,4,24]],"date-time":"2023-04-24T00:00:00Z","timestamp":1682294400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["T15LM007092\u201030"],"award-info":[{"award-number":["T15LM007092\u201030"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>In an era of vestibular schwannoma (VS) surgery where functional preservation is increasingly emphasized, persistent postoperative dizziness is a relatively understudied functional outcome. The primary objective was to develop a predictive model to identify patients at risk for developing persistent postoperative dizziness after VS resection.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Retrospective review of patients who underwent VS surgery at our institution with a minimum of 12\u2009months of postoperative follow\u2010up. Demographic, tumor\u2010specific, preoperative, and immediate postoperative features were collected as predictors. The primary outcome was self\u2010reported dizziness at 3\u2010, 6\u2010, and 12\u2010month follow\u2010up. Binary and multiclass machine learning classification models were developed using these features.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 1,137 cases were used for modeling. The median age was 67\u2009years, and 54% were female. Median tumor size was 2\u2009cm, and the most common approach was suboccipital (85%). Overall, 63% of patients did not report postoperative dizziness at any timepoint; 11% at 3\u2010month follow\u2010up; 9% at 6\u2010months; and 17% at 12\u2010months. Both binary and multiclass models achieved high performance with AUCs of 0.89 and 0.86 respectively. Features important to model predictions were preoperative headache, need for physical therapy on discharge, vitamin D deficiency, and systemic comorbidities.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>We demonstrate the feasibility of a machine learning approach to predict persistent dizziness following vestibular schwannoma surgery with high accuracy. These models could be used to provide quantitative estimates of risk, helping counsel patients on what to expect after surgery and manage patients proactively in the postoperative setting.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>4 <jats:italic>Laryngoscope<\/jats:italic>, 133:3534\u20133539, 2023<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.30708","type":"journal-article","created":{"date-parts":[[2023,4,24]],"date-time":"2023-04-24T08:48:43Z","timestamp":1682326123000},"page":"3534-3539","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Development of a Predictive Model for Persistent Dizziness Following Vestibular Schwannoma Surgery"],"prefix":"10.1002","volume":"133","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7517-0280","authenticated-orcid":false,"given":"Krish","family":"Suresh","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2014Head &amp; Neck Surgery Brigham and Women's Hospital  Boston Massachusetts U.S.A."},{"name":"Department of Otolaryngology\u2014Head &amp; Neck Surgery Massachusetts Eye &amp; Ear  Boston Massachusetts U.S.A."},{"name":"Department of Otolaryngology\u2014Head &amp; Neck Surgery Harvard Medical School  Boston Massachusetts U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed A.","family":"Elkahwagi","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head &amp; Neck Surgery Brigham and Women's Hospital  Boston Massachusetts U.S.A."},{"name":"Division of Otolaryngology\u2014Head &amp; Neck Surgery Mansoura University  Mansoura Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8204-8053","authenticated-orcid":false,"given":"Alejandro","family":"Garcia","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head &amp; Neck Surgery Massachusetts Eye &amp; Ear  Boston Massachusetts U.S.A."},{"name":"Department of Otolaryngology\u2014Head &amp; Neck Surgery Harvard Medical School  Boston Massachusetts U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James G.","family":"Naples","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head &amp; Neck Surgery Harvard Medical School  Boston Massachusetts U.S.A."},{"name":"Department of Otolaryngology\u2014Head &amp; Neck Surgery Beth Israel Deaconess Medical Center  Boston Massachusetts U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C. Eduardo","family":"Corrales","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head &amp; Neck Surgery Brigham and Women's Hospital  Boston Massachusetts U.S.A."},{"name":"Department of Otolaryngology\u2014Head &amp; Neck Surgery Harvard Medical School  Boston Massachusetts U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew G.","family":"Crowson","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head &amp; Neck Surgery Massachusetts Eye &amp; Ear  Boston Massachusetts U.S.A."},{"name":"Department of Otolaryngology\u2014Head &amp; Neck Surgery Harvard Medical School  Boston Massachusetts U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,4,24]]},"reference":[{"key":"e_1_2_7_2_1","first-page":"66","volume-title":"Comprehensive Management of Vestibular Schwannoma","author":"Ashour R","year":"2019"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599814551132"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.3171\/2014.11.JNS14594"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2021.770789"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000001664"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.25110"},{"issue":"4","key":"e_1_2_7_8_1","first-page":"484","article-title":"Assessment of dysequilibrium after acoustic neuroma removal","volume":"20","author":"Lynn SG","year":"1999","journal-title":"Am J Otol"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12916-014-0241-z"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/00129492-200307000-00019"},{"key":"e_1_2_7_11_1","unstructured":"Everything you need to know about linear discriminant analysis.2019Accessed January 28 2023.https:\/\/www.digitalvidya.com\/blog\/linear-discriminant-analysis\/."},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.20648"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/00129492-200307000-00021"},{"issue":"1","key":"e_1_2_7_14_1","first-page":"104","article-title":"Disability from vestibular symptoms after acoustic neuroma resection","volume":"19","author":"El\u2010Kashlan HK","year":"1998","journal-title":"Am J Otol"},{"issue":"4","key":"e_1_2_7_15_1","first-page":"491","article-title":"Preoperative identification of patients at risk of developing persistent dysequilibrium after acoustic neuroma removal","volume":"19","author":"Driscoll CL","year":"1998","journal-title":"Am J Otol"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.61.4.403"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1177\/000348940411301210"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0022215113003216"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/coa.13661"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.30516"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2022.838112"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/lio2.362"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000002886"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-021-08517-1"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-1-4614-6849-3"}],"container-title":["The Laryngoscope"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lary.30708","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,14]],"date-time":"2023-11-14T11:34:26Z","timestamp":1699961666000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/lary.30708"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,4,24]]},"references-count":24,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2023,12]]}},"alternative-id":["10.1002\/lary.30708"],"URL":"https:\/\/doi.org\/10.1002\/lary.30708","archive":["Portico"],"relation":{},"ISSN":["0023-852X","1531-4995"],"issn-type":[{"value":"0023-852X","type":"print"},{"value":"1531-4995","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,4,24]]},"assertion":[{"value":"2023-02-18","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-04-11","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-04-24","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}