von Kirschbaum Constantin, Gürkov Robert
Department of Otorhinolaryngology and Head and Neck Surgery, Grosshadern Medical Center, University of Munich, Marchioninistr. 15, 81377 Munich, Germany.
Biomed Res Int. 2016;2016:4980562. doi: 10.1155/2016/4980562. Epub 2016 Sep 22.
. Vestibular schwannomas (VS) are benign tumours of the vestibular nerve and can lead to hearing loss, tinnitus, vertigo, facial palsy, and brainstem compression. Audiovestibular diagnostic tests are essential for detection and treatment planning. . Medline was used to perform a systematic literature review with regard to how audiovestibular test parameters correlate with symptoms, tumour size, and tumour location. . The auditory brainstem response can be used to diagnose retrocochlear lesions caused by VS. Since hearing loss correlates poorly with tumour size, a retrocochlear lesion is probably not the only cause for hearing loss. Also cochlear mechanisms seem to play a role. This can be revealed by abnormal otoacoustic emissions, despite normal ABR and new MRI techniques which have demonstrated endolymphatic hydrops of the inner ear. Caloric and head impulse tests show frequency specific dynamics and vestibular evoked myogenic potentials may help to identify the location of the tumour regarding the involved nerve parts. . In order to preserve audiovestibular function in VS, it is important to stop the growth of the tumour and to avoid degenerative changes in the inner ear. A detailed neurotological workup helps to diagnose VS of all sizes and can also provide useful prognostic information.
前庭神经鞘瘤（VS）是前庭神经的良性肿瘤，可导致听力丧失、耳鸣、眩晕、面瘫和脑干受压。听前庭诊断测试对于检测和治疗规划至关重要。使用Medline对听前庭测试参数如何与症状、肿瘤大小和肿瘤位置相关进行系统的文献综述。听觉脑干反应可用于诊断由VS引起的蜗后病变。由于听力丧失与肿瘤大小的相关性较差，蜗后病变可能不是听力丧失的唯一原因。耳蜗机制似乎也起作用。这可通过异常耳声发射揭示，尽管ABR正常，且新的MRI技术已显示内耳存在内淋巴积水。冷热试验和头脉冲试验显示频率特异性动态变化，前庭诱发肌源性电位可能有助于确定肿瘤在受累神经部位方面的位置。为了保留VS患者的听前庭功能，阻止肿瘤生长并避免内耳发生退行性变化很重要。详细的神经耳科学检查有助于诊断各种大小的VS，还可提供有用的预后信息。
