在越来越注重功能保护的前庭神经鞘瘤（VS）手术时代中，持续的术后头晕是一个相对少被研究的功能结果。主要目标是制定一种预测模型，以识别哪些患者在VS切除术后容易出现持续的术后头晕。回顾性地审查了在我们机构接受VS手术且术后随访至少12个月的患者。搜集了人口统计学、肿瘤特异性、术前和术后即刻的特征作为预测因素。主要结果是自我报告的在3个月、6个月和12个月随访期间的头晕情况。使用这些特征建立了二元和多类机器学习分类模型。共有1,137个病例用于建模。中位年龄为67岁，54％为女性。中位肿瘤大小为2cm，最常见的方法是枕骨下入路（85％）。总体而言，63％的患者在任何时间点都没有报告术后头晕；11％在3个月的随访中报告；6个月时为9％；12个月时为17％。二元和多类模型都取得了高性能，其AUC分别为0.89和0.86。模型预测的重要特征包括术前头痛、出院时需要进行物理治疗、缺乏维生素D和系统性合并症。我们证明了一种机器学习方法来预测前庭神经鞘瘤手术后持续头晕的可行性，其精确度很高。这些模型可以用于提供风险的定量估计，帮助医生为患者在术后管理和术后康复方面进行咨询。 四级 《喉镜》2023年。© 2023年美国喉镜鼻科和耳科学会。

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.Retrospective review of patients who underwent VS surgery at our institution with a minimum of 12 months of postoperative follow-up. Demographic, tumor-specific, preoperative, and immediate postoperative features were collected as predictors. The primary outcome was self-reported dizziness at 3-, 6-, and 12-month follow-up. Binary and multiclass machine learning classification models were developed using these features.A total of 1,137 cases were used for modeling. The median age was 67 years, and 54% were female. Median tumor size was 2 cm, and the most common approach was suboccipital (85%). Overall, 63% of patients did not report postoperative dizziness at any timepoint; 11% at 3-month follow-up; 9% at 6-months; and 17% at 12-months. 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.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.Level IV Laryngoscope, 2023.© 2023 The American Laryngological, Rhinological and Otological Society, Inc.