Shi Xiaoling, Gong Jiamin, Yin Yanbo, Zhao Weidong, Wang Yunfeng
ENT Institute and Department of Otorhinolaryngology,EYE & ENT Hospital,Fudan University,Shanghai,200031,China.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2024 Dec;38(12):1114-1121. doi: 10.13201/j.issn.2096-7993.2024.12.005.
This study aimed to analyze the results of auditory and vestibular function tests in patients with unilateral vestibular schwannoma and explore their association with tumor size. Clinical data from 81 patients diagnosed with unilateral vestibular schwannoma who underwent pure-tone audiometry(PTA), cervical and ocular vestibular evoked myogenic potentials(c/oVEMP), as well as video head impulse test(vHIT), and subsequently underwent surgical treatment, were retrospectively analyzed. Patients were categorized into groups based on tumor size: small (≤ 15 mm), medium(16-30 mm), and large (>30 mm), determined by the maximum tumor diameter on contrast-enhanced MRI scans. PTA results indicated hearing loss in 73 cases(90.1%); vestibular function tests revealed abnormal rates for the anterior semicircular canal, horizontal semicircular canal, posterior semicircular canal, utricle, and saccule at 29.6%, 77.8%, 54.3%, 90.1%, and 92.6%, respectively. Statistically, no significant differences were found in preoperative hearing test results among patients in different groups(=0.393, =0.676). However, significant differences were observed in horizontal semicircular canal gain(=-0.248, =0.025), abnormal rates of horizontal semicircular canal catch-up saccades(=0.507, <0.001), as well as cVEMP(χ²=15.111, =0.004) and oVEMP thresholds(χ²=18.948, <0.001) across varying tumor size groups. The extent of hearing loss in patients with vestibular schwannoma is not correlated with tumor size, whereas the degree of vestibular dysfunction demonstrates a correlation with tumor size.
本研究旨在分析单侧前庭神经鞘瘤患者的听觉和前庭功能测试结果,并探讨其与肿瘤大小的关联。对81例经诊断为单侧前庭神经鞘瘤并接受了纯音听力测定(PTA)、颈肌和眼肌前庭诱发肌源性电位(c/oVEMP)以及视频头脉冲试验(vHIT),随后接受手术治疗的患者的临床资料进行回顾性分析。根据增强磁共振成像扫描上肿瘤的最大直径,将患者分为小(≤15 mm)、中(16 - 30 mm)、大(>30 mm)三组。PTA结果显示73例(90.1%)患者存在听力损失;前庭功能测试显示,前半规管、水平半规管、后半规管、椭圆囊和球囊的异常率分别为29.6%、77.8%、54.3%、90.1%和92.6%。统计学分析显示,不同组患者术前听力测试结果无显著差异(F = 0.393,P = 0.676)。然而,在不同肿瘤大小组之间,水平半规管增益(F = -0.248,P = 0.025)、水平半规管追赶性扫视异常率(χ² = 0.507,P < 0.001)以及cVEMP(χ² = 15.111,P = 0.004)和oVEMP阈值(χ² = 18.948,P < 0.001)存在显著差异。前庭神经鞘瘤患者的听力损失程度与肿瘤大小无关,而前庭功能障碍程度与肿瘤大小相关。