Department of Otorhinolaryngology Head and Neck Surgery and Audiology, Rigshospitalet, University Hospital of Copenhagen.
Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
Otol Neurotol. 2020 Jun;41(5):e623-e629. doi: 10.1097/MAO.0000000000002600.
No previous studies have investigated a vestibular function test battery combining the Video Head Impulse Test (VHIT), the caloric test, and the cervical vestibular evoked myogenic potential (cVEMP) test. The objective was to investigate the sensitivity of the three vestibular tests to the presence of a vestibular schwannomas (VS), and possible correlations between test results, hearing acuity, and tumor size.
Retrospective cohort study.
University hospital.
Fifty-nine patients with a unilateral VS.
Audio-vestibular tests; the VHIT, cVEMP, caloric irrigation, pure-tone audiometry, and speech discrimination.
Findings, sensitivity, and correlations between VHIT saccades and gain; cVEMP potentials, unilateral caloric weakness; hearing acuity.
The sensitivity for VS was 80% for the VHIT, 93% for the caloric test, and 73% for the cVEMP test. VHIT gain and saccades were associated, and both had a positive correlation to caloric function. Medium-sized tumors demonstrated the highest gain asymmetry while larger tumors were associated with saccades. There was a weak correlation between vestibular findings and hearing acuity.
The VHIT is sensitive to the occurrence of a VS, but less so than the caloric test, and vestibular function deteriorates to some extent with increasing tumor size. VHIT outcomes are positively correlated to caloric function, but only vaguely to cVEMP and hearing acuity. The combined vestibular function test battery reached a sensitivity of 97% to the occurrence of a VS and could thus potentially substitute MRI for tumor screening upon the diagnosis of an asymmetrical hearing loss.
既往研究尚未探讨过视频头脉冲试验（VHIT）、冷热试验和颈性前庭诱发肌源性电位（cVEMP）试验相结合的前庭功能测试组合。本研究旨在研究三种前庭测试对前庭神经鞘瘤（VS）存在的敏感性，以及测试结果、听力和肿瘤大小之间的可能相关性。
回顾性队列研究。
大学医院。
59 例单侧 VS 患者。
听觉前庭测试；VHIT、cVEMP、冷热刺激、纯音听阈和言语辨别测试。
VHIT 扫视和增益的发现、敏感性和相关性；cVEMP 电位、单侧冷热刺激减弱；听力。
VHIT 对 VS 的敏感性为 80%，冷热试验为 93%，cVEMP 试验为 73%。VHIT 增益和扫视相关，两者均与冷热功能呈正相关。中等大小的肿瘤表现出最高的增益不对称性，而较大的肿瘤与扫视相关。前庭发现与听力之间存在弱相关性。
VHIT 对 VS 的发生敏感，但不及冷热试验，并且随着肿瘤体积的增大，前庭功能会在一定程度上恶化。VHIT 结果与冷热功能呈正相关，但与 cVEMP 和听力仅呈微弱相关。联合前庭功能测试组合对 VS 的发生率达到 97%，因此在诊断单侧听力损失时，有可能替代 MRI 进行肿瘤筛查。
