Cargando…

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...

Descripción completa

Detalles Bibliográficos
Autores principales: Califano, L., Salafia, F., Melillo, M.G., Mazzone, S.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Pacini Editore SRL 2017
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
_version_ 1783261407352979456
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
work_keys_str_mv AT califanol sensitivityandspecificityofvestibularbedsideexaminationindetectingviiicranialnerveschwannomawithsensorineuralsuddenunilateralhearinglossaspresentingsymptom
AT salafiaf sensitivityandspecificityofvestibularbedsideexaminationindetectingviiicranialnerveschwannomawithsensorineuralsuddenunilateralhearinglossaspresentingsymptom
AT melillomg sensitivityandspecificityofvestibularbedsideexaminationindetectingviiicranialnerveschwannomawithsensorineuralsuddenunilateralhearinglossaspresentingsymptom
AT mazzones sensitivityandspecificityofvestibularbedsideexaminationindetectingviiicranialnerveschwannomawithsensorineuralsuddenunilateralhearinglossaspresentingsymptom