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Preoperative vestibular function of patients with vestibular schwannoma
18 April 2018 (online)
Vestibular schwannomas (VS) arise from Schwann cells of one of the branches of the vestibular nerve. Patients suffer from hearing loss, tinnitus or vertigo. The vestibular function of the low frequent vestibular receptors of the horizontal semi-circular canal is usually determined by caloric testing. Recently, video head impulse test (VHIT) was established as a method to investigate the high frequency vestibular receptors of all 6 semi-circular canals. It was demonstrated that application of both methods can lead to more extensive knowledge of preoperative vestibular function, size of tumour or localization of tumour of VS.
Retrospectively, 50 patients with VS were included that showed up preoperatively at the ENT University hospital Wuerzburg during the year 2015. Size of tumour was graded according to Koos-classification. An internal dizziness questionnaire, video nystagmography, caloric testing and VHIT (gain/saccades) were evaluated.
Size of tumour correlated with both kinds of diagnostic tools. Reduction of vestibular function was detected earlier with caloric testing in this group of patients. VHIT can indicate the origin of the tumour.
Preoperative consultation and decision of therapy in VS can be improved by the use of a combination of VHIT and caloric testing further. In future results of preoperative tests of vestibular function should be compared with intraoperative findings.