Evaluation of Vestibular Function in Diagnosis of Vestibular Schwannomas

Abstract

Vestibular schwannomas (VS) are benign tumors of the vestibular nerve. The common first symptoms are hearing loss and tinnitus, followed by imbalance, vertigo, and facial nerve involvement. The subjective symptoms of VS patients are not consistent with the severity of vestibular lesions and the results of vestibular tests, which often interfere with clinicians’ diagnoses. Thus, the main screening and diagnostic methods for VS are audiometry and magnetic resonance imaging (MRI), ignoring the evaluation of vestibular function at the source of pathological lesions. With the development and improvement of vestibular evaluation technology and its wide application in the clinic, modern vestibular examination technology can reflect the severity and frequency of vestibular lesions and compensation from multiple perspectives, providing an objective basis for the diagnosis and treatment of vestibular diseases. In this report, we review the results and characteristics of vestibular tests in VS patients and further clarify the clinical value of vestibular function assessment in the diagnosis and treatment of VS.

Keywords

vestibular schwannomas / vestibular function test / vestibular compensation / vertigo

References

[1] St MartinMB, HirschBE. Imaging of hearing loss. Otolaryngol Clin North Am, 2008, 41(1): 157-178

[2] LinD, HegartyJL, FischbeinNJ, et al.. The prevalence of “incidental” acoustic neuroma. Arch Otolaryngol Head Neck Surg, 2005, 131(3): 241-244

[3] MorcosJJ. Vestibular schwannomas. J Neurosurg, 2013, 118(3): 550-553

[4] ProppJM, McCarthyBJ, DavisFG, et al.. Descriptive epidemiology of vestibular schwannomas. Neuro Oncol, 2006, 8(1): 1-11

[5] PandrangiVC, HanAY, AlonsoJE, et al.. An Update on Epidemiology and Management Trends of Vestibular Schwannomas. Otol Neurotol, 2020, 41(3): 411-417

[6] KentalaE, PyykkoI. Clinical picture of vestibular schwannoma. Auris Nasus Larynx, 2001, 28(1): 15-22

[7] GoldbrunnerR, WellerM, RegisJ, et al.. EANO guideline on the diagnosis and treatment of vestibular schwannoma. Neuro Oncol, 2020, 22(1): 31-45

[8] AndersenJF, NilsenKS, VassbotnFS, et al.. Predictors of vertigo in patients with untreated vestibular schwannoma. Otol Neurotol, 2015, 36(4): 647-652

[9] NamGS, JungCM, KimJH, et al.. Relationship of Vertigo and Postural Instability in Patients With Vestibular Schwannoma. Clin Exp Otorhinolaryngol, 2018, 11(2): 102-108

[10] WellingDB, GlasscockME, WoodsCI, et al.. Acoustic neuroma: a cost-effective approach. Otolaryngol Head Neck Surg, 1990, 103(3): 364-370

[11] CharabiS. Acoustic neuroma/vestibular schwannoma in vivo and in vitro growth models. A clinical and experimental study. Acta Otolaryngol Suppl, 1997, 530: 1-27

[12] DayAS, WangCT, ChenCN, et al.. Correlating the cochleovestibular deficits with tumor size of acoustic neuroma. Acta Otolaryngol, 2008, 128(7): 756-760

[13] GouverisH, AkkafaS, LippoldR, et al.. Influence of nerve of origin and tumor size of vestibular schwannoma on dynamic posturography findings. Acta Otolaryngol, 2006, 126(12): 1281-1285

[14] HoffmannCP, SeigleB, FrereJ, et al.. Dynamical analysis of balance in vestibular schwannoma patients. Gait Posture, 2017, 54: 236-241

[15] von KirschbaumC, GurkovR. Audiovestibular Function Deficits in Vestibular Schwannoma. Biomed Res Int, 2016, 2016: 4980562

[16] StipkovitsEM, Van DijkJE, GraamansK. Electronystagmographic changes in patients with unilateral vestibular schwannomas in relation to tumor progression and central compensation. Eur Arch Otorhinolaryngol, 1999, 256(4): 173-176

[17] WestN, SassH, KlokkerM, et al.. Video Head Impulse Test Results in Patients With a Vestibular Schwannoma-Sensitivity and Correlation With Other Vestibular System Function Tests, Hearing Acuity, and Tumor Size. Otol Neurotol, 2020, 41(5): e623-e629

[18] TringaliS, CharpiotA, OuldMB, et al.. Characteristics of 629 vestibular schwannomas according to preoperative caloric responses. Otol Neurotol, 2010, 31(3): 467-472

[19] BlodowA, HelbigR, WichmannN, et al.. The video head impulse test: first clinical experiences. HNO, 2013, 61(4): 327-334

[20] HebbALO, ErjavecN, MorrisDP, et al.. Quality of life related to symptomatic outcomes in patients with vestibular schwannomas: A Canadian Centre perspective. Am J Otolaryngol, 2019, 40(2): 236-246

[21] KimHJ, ParkSH, KimJS, et al.. Bilaterally Abnormal Head Impulse Tests Indicate a Large Cerebellopontine Angle Tumor. J Clin Neurol, 2016, 12(1): 65-74

[22] BorgmannH, LenarzT, LenarzM. Preoperative prediction of vestibular schwannoma’s nerve of origin with posturography and electronystagmography. Acta Otolaryngol, 2011, 131(5): 498-503

[23] UshioM, IwasakiS, ChiharaY, et al.. Is the nerve origin of the vestibular schwannoma correlated with vestibular evoked myogenic potential, caloric test, and auditory brainstem response?. Acta Otolaryngol, 2009, 129(10): 1095-1100

[24] WagnerJN, GlaserM, WowraB, et al.. Vestibular function and quality of life in vestibular schwannoma: does size matter?. Front Neurol, 2011, 2: 55

[25] TeggiR, FranzinA, SpatolaG, et al.. Vestibular assessment in patients with vestibular schwannomas: what really matters?. Acta Otorhinolaryngologica Italica Organo Ufficiale Della Società Italiana Di Otorinolaringologia E Chirurgia Cervico Facciale, 2014, 34(2): 123-128

[26] StidhamKR, RobersonJB. Hearing improvement after middle fossa resection of vestibular schwannoma. Otology & Neurotology, 2001, 22(6): 917-921

[27] Bloching, Boris M, Bloedow, et al. Horizontal VOR function shows frequency dynamics in vestibular schwannoma. European archives of oto-rhino-laryngology: Official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS), 2015

[28] ConstanzoF, SensP, TeixeiraBCA, et al.. Video Head Impulse Test to Preoperatively Identify the Nerve of Origin of Vestibular Schwannomas. Oper Neurosurg (Hagerstown), 2019, 16(3): 319-325

[29] Jorns-HaderliM, StraumannD, PallaA. Accuracy of the bedside head impulse test in detecting vestibular hypofunction. J Neurol Neurosurg Psychiatry, 2007, 78(10): 1113-1118

[30] HalmagyiGM, CurthoysIS, CremerPD, et al.. The human horizontal vestibulo-ocular reflex in response to high-acceleration stimulation before and after unilateral vestibular neurectomy. Exp Brain Res, 1990, 81(3): 479-490

[31] O’LearyDP, DavisLL. High-frequency auorotational testing of the vestibuloocular reflex. Neurologic Clinics, 1990, 8(2): 297-312

[32] HirvonenTP, PyykkoI, AaltoH, et al.. Vestibulo-ocular reflex function as measured with the head autorotation test. Acta Otolaryngol, 1997, 117(5): 657-662

[33] YanT, ZongF, HanX, et al.. Vestibular Neuritis in Patients Among Different Age Groups: Clinical Features and Outcomes. J Am Acad Audiol, 2020, 31(9): 629-635

[34] RosengrenSM, WelgampolaMS, ColebatchJG. Vestibular evoked myogenic potentials: past, present and future. Clin Neurophysiol, 2010, 121(5): 636-651

[35] KantnerC, GurkovR. Characteristics and clinical applications of ocular vestibular evoked myogenic potentials. Hear Res, 2012, 294(1–2): 55-63

[36] AdamecI, SkoricMK, HandzicJ, et al.. The role of cervical and ocular vestibular-evoked myogenic potentials in the follow-up of vestibular neuritis. Clin EEG Neurosci, 2014, 45(2): 129-136

[37] IwasakiS, MurofushiT, ChiharaY, et al.. Ocular vestibular evoked myogenic potentials to bone-conducted vibration in vestibular schwannomas. Otol Neurotol, 2010, 31(1): 147-152

[38] ChurchS, MurofushiT, ChiharaY, et al.. Endocarditis caused by Pasteurella caballi in a horse. Aust Vet J, 1998, 76(8): 528-530

[39] UshioM, MatsuzakiM, TakegoshiH, et al.. Click- and short tone burst-evoked myogenic potentials in cerebellopontine angle tumors. Acta Otolaryngol Suppl, 2001, 545: 133-135

[40] HuYF, ChengPW, YoungYH. Comparison of vestibular function between large cerebellopontine angle meningioma and schwannoma. Acta Otolaryngol, 2009, 129(2): 161-165

[41] GouverisH, HellingK, VictorA, et al.. Comparison of electronystagmography results with dynamic posturography findings in patients with vestibular schwannoma. Acta Otolaryngol, 2007, 127(8): 839-842

[42] GouverisH, StripfT, VictorA, et al.. Dynamic posturography findings predict balance status in vestibular schwannoma patients. Otology & Neurotology, 2007, 28(3): 372-375

[43] RibeyreL, FrereJ, GauchardG, et al.. Preoperative balance control compensation in patients with a vestibular schwannoma: does tumor size matter?. Clin Neurophysiol, 2015, 126(4): 787-793

[44] YinM, IshikawaK, OmiE, et al.. Small vestibular schwannomas can cause gait instability. Gait Posture, 2011, 34(1): 25-28

[45] PagarkarW, BamiouDE, RidoutD, et al.. Subjective visual vertical and horizontal: effect of the preset angle. Arch Otolaryngol Head Neck Surg, 2008, 134(4): 394-401

[46] ZhaoY, ChenT, WangW, et al.. The application of subjective visual gravity in assessment of vestibular compensation: a pilot study. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi, 2016, 51(5): 355-360

[47] CadaZ, BalatkovaZ, CakrtO, et al.. Predictors of central vestibular compensation after surgery for vestibular schwannomas. Acta Otorhinolaryngol Ital, 2019, 39(1): 46-52

[48] ThomeerH, BonnardD, Franco-VidalV, et al.. Prognostic Factors of Balance Quality After Transpetrosal Vestibular Schwannoma Microsurgery: An Instrumentally and DHI-based Prospective Cohort Study of 48 Patients. Otol Neurotol, 2015, 36(5): 886-891

[49] FurmanJM, BalabanCD, PollackIF. Vestibular compensation in a patient with a cerebellar infarction. Neurology, 1997, 48(4): 916-920

[50] BreivikCN, NilsenRM, MyrsethE, et al.. Working disability in Norwegian patients with vestibular schwannoma: vertigo predicts future dependence. World Neurosurg, 2013, 80(6): e301-e305

[51] DayalM, Perez-AndujarA, ChuangC, et al.. Management of vestibular schwannoma: focus on vertigo. CNS Oncol, 2013, 2(1): 99-104

[52] ZhouY, ZhaoW, TianL, et al.. The prediction of the tumor size of a vestibular schwannoma by clinical performance and vestibular function tests. J Neurooncol, 2018, 140(3): 679-686

[53] HallidayJ, RutherfordSA, McCabeMG, et al.. An update on the diagnosis and treatment of vestibular schwannoma. Expert Rev Neurother, 2018, 18(1): 29-39