Audiological Evaluation in Unilateral Vestibular Schwannoma: What Information Does it Provide in Routine Clinical Practice?
摘要
Audiological test-battery [(pure-tone audiometry(PTA), word-recognition scores(WRS), acoustic reflexes(AR), distortion product otoacoustic emissions(DPOAE), auditory brainstem response(ABR), cervical(cVEMP), and ocular vestibular evoked myogenic potentials(oVEMP)] has been investigated in various combinations among VS patients. However, none of these studies have examined all tests in the same population. Hence the aim of the study is to evaluate the usefulness of the above-mentioned audiological test-battery in unilateral VS during routine audiological clinical practice.
MethodsTwenty-five participants with radiologically diagnosed unilateral VS using gadolinium-enhanced-MRI were prospectively studied. All participants underwent routine clinical examination and the above-mentioned audiological test-battery and results were statistically analysed and related to the tumour grades.
ResultsThe size of the tumour was small(n = 1), medium(n = 3), moderately-large(n = 5), large(n = 10), and giant(n = 6). The abnormality rates of PTA, WRS, AR, DPOAE, ABR, cVEMP, oVEMP on the lesion-side were 92%, 84%, 92%, 84%, 100%, 92%, 100%, respectively. All these tests did not show any relationship with the tumour grades except WRS.
ConclusionAmong the audiological test-battery, ABR and oVEMP were the most sensitive tests to identify tumours, especially oVEMP in unilateral profound sensorineural hearing loss. Though gadolinium-enhanced-MRI is the gold-standard test, audiological screening using ABR and/or oVEMP is a good choice to screen and identify patients with possible VS.