The neurotologic evaluation of vestibular schwannomas. Results of audiological and vestibular testing in 100 consecutive cases

摘要: OBJECTIVES To determine the results and sensitivity of a comprehensive audiological vestibular work-up in patients presenting with schwannoma (VS). MATERIAL AND METHODS One hundred consecutive cases VS diagnosed from January 2004 to May 2005 were prospectively studied. The tumour size was classified according Koos classification hearing assessed five-stage Tokyo consensus. A conducted all patients, including pure tone speech audiometry, Brainstem Evoked Audiologic Potentials (BEAP) assessment, Vestibular Myogenic (VEMP) examination bithermal caloric testing using videonystagmography, on both sides. BEAP responses considered as normal or endocochlear when interwave intervals normal, absent because poor retrocochlear wave 1 5 interval > 4.3 ms and/or this greater than 0.25 between sides, no response recorded preserved. VEMP diminished (amplitude = 30%) (reduced by 80%). RESULTS Fifty-six women 44 men examined (mean age 57.8 years). Left right side equally affected. Vertigo, tinnitus loss main symptom 21%, 32% 68% cases, respectively. Eighty-two per cent operated, 17% simply monitored 1% irradiated. tumours Stage 1, 2, 3 4 14%, 28%, 21% 37%, Hearing class 9%, Class B 34%, C 14% E-D 43% cases. Globally, showed pattern 64% 30%. Abnormal observed 94% Caloric abnormal 61% 11%. Responses could not be analyzed 28% patients. Only one patient whole (99% sensitivity). This had small intrameatal actually complained contralateral symptoms. CONCLUSION suggest that full audiovestibular assessment can help diagnose sizes. But false-negative remain possible (1%). In addition it give useful postoperative prognostic information.