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Sensitivity and specificity of vestibular bed-side examination in detecting VIII cranial nerve schwannoma with sensorineural sudden unilateral hearing loss as presenting symptom
The objectives of this study were to identify signs of vestibular nerve suffering through a bedside vestibular examination protocol in case of sudden sensorineural unilateral hearing loss without spontaneous signs of vestibular impairment and to propose a bed-side vestibular examination based protoc...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Pacini Editore SRL
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5584107/ https://www.ncbi.nlm.nih.gov/pubmed/28530253 http://dx.doi.org/10.14639/0392-100X-1284 |
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author | Califano, L. Salafia, F. Melillo, M.G. Mazzone, S. |
author_facet | Califano, L. Salafia, F. Melillo, M.G. Mazzone, S. |
author_sort | Califano, L. |
collection | PubMed |
description | The objectives of this study were to identify signs of vestibular nerve suffering through a bedside vestibular examination protocol in case of sudden sensorineural unilateral hearing loss without spontaneous signs of vestibular impairment and to propose a bed-side vestibular examination based protocol for the focused execution of gadolinium-enhanced magnetic resonance imaging (MRI) only if a vestibular schwannoma is suspected. 96 patients, 52 men, 44 women, mean age 57.73 +/- 12.85 years, suffering from sudden sensorineural unilateral hearing loss, which presented neither vertigo nor spontaneous nystagmus, were enrolled. Pure tone audiometry, tympanometry, measurement of acoustic reflexes and Anderson test to detect adaptation, bedside vestibular examination through head shaking test, vibration test, head impulse test, hyperventilation test and detection of nystagmus in supine and lateral decubitus to search for signs of vestibular impairment were performed. Patients with signs of vestibular impairment and pure tone audiometry threshold at high frequencies better than 70 dB nHL were subjected to auditory brainstem responses. Gadolinium enhanced MRI centred on internal acoustic canals was carried out in all patients with sudden sensorineural unilateral hearing loss. Main outcome measures were signs of vestibular impairment at vestibular bedside examination and presence of vestibular schwannoma on MRI. Signs of vestibular impairment were detected in 22/96 cases (22.9%); a vestibular schwannoma was detected by MRI in 5/96 cases (5.2%), always when vestibular impairment was present. In case of sudden sensorineural unilateral hearing loss, vestibular bedside examination seems to be useful to restrict the suspicion of a vestibular schwannoma to cases with signs of vestibular impairment, reducing the number of MRI exams, with considerable economic savings. |
format | Online Article Text |
id | pubmed-5584107 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Pacini Editore SRL |
record_format | MEDLINE/PubMed |
spelling | pubmed-55841072017-09-12 Sensitivity and specificity of vestibular bed-side examination in detecting VIII cranial nerve schwannoma with sensorineural sudden unilateral hearing loss as presenting symptom Califano, L. Salafia, F. Melillo, M.G. Mazzone, S. Acta Otorhinolaryngol Ital Vestibology The objectives of this study were to identify signs of vestibular nerve suffering through a bedside vestibular examination protocol in case of sudden sensorineural unilateral hearing loss without spontaneous signs of vestibular impairment and to propose a bed-side vestibular examination based protocol for the focused execution of gadolinium-enhanced magnetic resonance imaging (MRI) only if a vestibular schwannoma is suspected. 96 patients, 52 men, 44 women, mean age 57.73 +/- 12.85 years, suffering from sudden sensorineural unilateral hearing loss, which presented neither vertigo nor spontaneous nystagmus, were enrolled. Pure tone audiometry, tympanometry, measurement of acoustic reflexes and Anderson test to detect adaptation, bedside vestibular examination through head shaking test, vibration test, head impulse test, hyperventilation test and detection of nystagmus in supine and lateral decubitus to search for signs of vestibular impairment were performed. Patients with signs of vestibular impairment and pure tone audiometry threshold at high frequencies better than 70 dB nHL were subjected to auditory brainstem responses. Gadolinium enhanced MRI centred on internal acoustic canals was carried out in all patients with sudden sensorineural unilateral hearing loss. Main outcome measures were signs of vestibular impairment at vestibular bedside examination and presence of vestibular schwannoma on MRI. Signs of vestibular impairment were detected in 22/96 cases (22.9%); a vestibular schwannoma was detected by MRI in 5/96 cases (5.2%), always when vestibular impairment was present. In case of sudden sensorineural unilateral hearing loss, vestibular bedside examination seems to be useful to restrict the suspicion of a vestibular schwannoma to cases with signs of vestibular impairment, reducing the number of MRI exams, with considerable economic savings. Pacini Editore SRL 2017-08 /pmc/articles/PMC5584107/ /pubmed/28530253 http://dx.doi.org/10.14639/0392-100X-1284 Text en © Copyright by Società Italiana di Otorinolaringologia e Chirurgia Cervico-Facciale, Rome, Italy http://creativecommons.org/licenses/by-nc-nd/3.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives License, which permits for noncommercial use, distribution, and reproduction in any digital medium, provided the original work is properly cited and is not altered in any way. For details, please refer to http://creativecommons.org/licenses/by-nc-nd/3.0/ |
spellingShingle | Vestibology Califano, L. Salafia, F. Melillo, M.G. Mazzone, S. Sensitivity and specificity of vestibular bed-side examination in detecting VIII cranial nerve schwannoma with sensorineural sudden unilateral hearing loss as presenting symptom |
title | Sensitivity and specificity of vestibular
bed-side examination in detecting VIII cranial nerve
schwannoma with sensorineural sudden unilateral
hearing loss as presenting symptom |
title_full | Sensitivity and specificity of vestibular
bed-side examination in detecting VIII cranial nerve
schwannoma with sensorineural sudden unilateral
hearing loss as presenting symptom |
title_fullStr | Sensitivity and specificity of vestibular
bed-side examination in detecting VIII cranial nerve
schwannoma with sensorineural sudden unilateral
hearing loss as presenting symptom |
title_full_unstemmed | Sensitivity and specificity of vestibular
bed-side examination in detecting VIII cranial nerve
schwannoma with sensorineural sudden unilateral
hearing loss as presenting symptom |
title_short | Sensitivity and specificity of vestibular
bed-side examination in detecting VIII cranial nerve
schwannoma with sensorineural sudden unilateral
hearing loss as presenting symptom |
title_sort | sensitivity and specificity of vestibular
bed-side examination in detecting viii cranial nerve
schwannoma with sensorineural sudden unilateral
hearing loss as presenting symptom |
topic | Vestibology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5584107/ https://www.ncbi.nlm.nih.gov/pubmed/28530253 http://dx.doi.org/10.14639/0392-100X-1284 |
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