West Niels, Møller Martin Nue, Hansen Søren, Cayé-Thomasen Per
Department of Otorhinolaryngology, Head and Neck Surgery, Rigshospitalet, Copenhagen, Denmark.
University of Copenhagen, School of Health and Medical Sciences, Copenhagen, Denmark.
J Int Adv Otol. 2018 Aug;14(2):161-165. doi: 10.5152/iao.2018.5500.
The aim of the present study was to investigate the relationships between tumor size, hearing, and vestibular outcomes in patients with vestibular schwannomas (VSs).
Adult patients (n=124) with unilateral extrameatal VS prior to surgery were included in the study. This was a retrospective cohort study of preoperative audiovestibular investigations including audiometry, discrimination test, caloric test, cervical vestibular evoked myogenic potential (c-VEMP), and ocular vestibular evoked myogenic potential (o-VEMP).
The difference between lesioned and non-lesioned ear was significant for all audiovestibular outcomes. The mean caloric deficit was 74%. No tumor sided o-VEMPs were elicited. Caloric deficit correlated with hearing loss measured with pure tone average and discrimination score. c-VEMP deficit was significantly associated with severe hearing loss and larger tumors.
The presence of VS leads to a significant deterioration of audiovestibular function in all objective measures. Caloric test and o-VEMPS are sensitive though unspecific measures of VSs. Increasing tumor size is not directly associated with hearing loss and only somewhat to vestibular deficit. However, audiovestibular findings are correlated.
本研究旨在探讨前庭神经鞘瘤（VS）患者的肿瘤大小、听力和前庭功能结果之间的关系。
本研究纳入了124例术前单侧外耳道VS成年患者。这是一项关于术前听前庭检查的回顾性队列研究，检查包括听力测定、辨别试验、冷热试验、颈前庭诱发肌源性电位（c-VEMP）和眼前庭诱发肌源性电位（o-VEMP）。
所有听前庭功能结果在患侧耳与未患侧耳之间差异显著。平均冷热试验减退率为74%。未引出肿瘤侧的o-VEMP。冷热试验减退率与纯音平均听阈及辨别得分所测得的听力损失相关。c-VEMP减退与严重听力损失及较大肿瘤显著相关。
VS的存在导致所有客观指标下听前庭功能显著恶化。冷热试验和o-VEMP是VS敏感但非特异性的检测方法。肿瘤大小增加与听力损失无直接关联，仅与前庭功能减退有一定关联。然而，听前庭检查结果具有相关性。
