Maurer J
Klinik für HNO-Krankheiten, Kopf-, Hals- und Schädelbasischirurgie und Zentrum für Hören und Kommunikation, Katholisches Klinikum Koblenz, Koblenz.
Laryngorhinootologie. 2008 Aug;87(8):585-96; quiz 597-600. doi: 10.1055/s-2008-1077429.
For acoustic tumours > 2 cm the sensitivity of brainstem evoked auditory potentials (BAEP) to detect the retrocochlear lesions is 100 % as for magnetic resonance imaging (MRI). According to the literature the sensitivity for detection of retrocochlear pathology in tumours < 1 cm is estimated to be between 75 % and 95 %. In the MRI the sensitivity and specificity in such smaller tumours is reported to be 100 %. A normal result of the BAEP examination and for additional neurootologic tests helps to increase the rate of safe exclusion of retrocochlear pathology. By at this time not yet routinely available modifications of the BAEP examination and by additional neurootologic tests the sensitivity of the electrophysiological screening procedure can be brought up to nearly 100 %. Thereby their important role as the primary screening procedure can be re-established. Besides a possible detection of a retrocochlear lesion the BAEP together with the additional neurootologic test provide important information on the functional status of the hearing and equilibrium system. Possible safe indications for inclusion and for exclusion criteria of an MRI screening for individual patients will be provided and discussed.
对于直径大于2厘米的听神经瘤,脑干听觉诱发电位(BAEP)检测蜗后病变的灵敏度与磁共振成像(MRI)相同,均为100%。据文献报道,对于直径小于1厘米的肿瘤,检测蜗后病变的灵敏度估计在75%至95%之间。在MRI检查中,这类较小肿瘤的灵敏度和特异性据报道均为100%。BAEP检查结果正常以及进行其他耳神经学检查有助于提高安全排除蜗后病变的比率。通过目前尚未常规应用的BAEP检查改进方法以及其他耳神经学检查,电生理筛查程序的灵敏度可提高至近100%。从而可以重新确立其作为主要筛查程序的重要作用。除了可能检测到蜗后病变外,BAEP连同其他耳神经学检查还能提供有关听力和平衡系统功能状态的重要信息。将提供并讨论针对个体患者进行MRI筛查的可能安全纳入和排除标准。