Borgmann Hendrik, Lenarz Thomas, Lenarz Minoo
Department of Otolaryngology, Medical University of Hannover, Carl-Neuberg-Strasse 1, Hannover, Germany.
Acta Otolaryngol. 2011 May;131(5):498-503. doi: 10.3109/00016489.2010.536991. Epub 2010 Dec 16.
Chances of hearing preservation are better in patients with vestibular schwannoma (VS) from the superior vestibular nerve (SVN) than from the inferior vestibular nerve (IVN). Pathologic posturography and electronystagmography (ENG) findings are more common in schwannomas from the SVN compared with tumors from the IVN. In this way, computerized dynamic platform posturography (CDPP) and ENG contribute to predict the nerve of origin of VS and can be used indirectly as a prognostic factor for hearing preservation.
To test whether preoperative CDPP or ENG results contribute to predict the nerve of origin in VS and also to evaluate the influence of the nerve of origin on hearing preservation.
Eighty-nine patients with VS originating from the IVN and 22 patients with VS from the SVN were included. Hearing loss due to surgery was calculated on postoperative and preoperative audiograms. Caloric response was measured by ENG and condition 5 and 6 score were recorded by CDPP before surgery.
Hearing loss due to surgery was significantly lower in patients with tumors from the SVN than from the IVN (p = 0.011). Pathologic results in preoperative ENG (p < 0.0001) and CDPP (p = 0.025) were significantly more frequent in subjects with SVN than with IVN schwannomas.
前庭神经鞘瘤（VS）起源于上前庭神经（SVN）的患者听力保留的机会比起源于下前庭神经（IVN）的患者更好。与起源于IVN的肿瘤相比，起源于SVN的神经鞘瘤的病理姿势描记法和眼震电图（ENG）结果更为常见。通过这种方式，计算机化动态平台姿势描记法（CDPP）和ENG有助于预测VS的起源神经，并可间接用作听力保留的预后因素。
测试术前CDPP或ENG结果是否有助于预测VS的起源神经，并评估起源神经对听力保留的影响。
纳入89例起源于IVN的VS患者和22例起源于SVN的VS患者。根据术后和术前听力图计算手术导致的听力损失。术前通过ENG测量冷热试验反应，并通过CDPP记录条件5和6评分。
起源于SVN的肿瘤患者手术导致的听力损失明显低于起源于IVN的患者（p = 0.011）。起源于SVN的神经鞘瘤患者术前ENG（p < 0.0001）和CDPP（p = 0.025）的病理结果明显比起源于IVN的神经鞘瘤患者更常见。
