CC BY-NC-ND 4.0 · Laryngorhinootologie 2018; 97(S 02): S237
DOI: 10.1055/s-0038-1640535
Otologie: Otology
Georg Thieme Verlag KG Stuttgart · New York

Preoperative determination of nerve of origin in patients with vestibular schwannoma

T Rahne
1  Universitätsklinikum Halle (Saale), HNO-Klinik, Halle/S.
S Plößl
1  Universitätsklinikum Halle (Saale), HNO-Klinik, Halle/S.
S Plontke
1  Universitätsklinikum Halle (Saale), HNO-Klinik, Halle/S.
C Strauß
2  Universitätsklinikum Halle (Saale), Neurochirurgie, Halle/S.
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18. April 2018 (online)



Vestibular schwannoma (VS) is a benign tumor that develops in the internal auditory canal and the cerebellopontine angle, potentially diminishing hearing or balance. Most VS tumors arise from one of two vestibular branches: the superior or inferior vestibular nerve. Determining the specific nerve of origin could improve patient management in terms of preoperative counseling, treatment selection, and operative decision-making and planning. The aim of this study was to assess a novel scoring system that was designed to predict the nerve of origin.


The nerve of origin was predicted based on video head-impulse assessments of all semicircular channels, together with cervical/ocular vestibular-evoked myogenic potential tests. The acquired data were entered into a scoring system developed to allocate the tumor origin. Finally, the nerve of origin was definitively determined intraoperatively.


In 85% of cases, the preoperatively predicted tumor origin was the same as the origin determined during surgery. The remaining 15% showed an indifferent or wrong prediction. Thus, the overall classification accuracy was 85%.


Our present data suggest that the novel scoring system shows promise for identifying the nerve of origin of VS. In this small-scale study, this scoring system could differentiate between the superior and inferior vestibular nerves. The agreement between the preoperative and intraoperative findings suggests that a larger prospective study is warranted.