Research in Vestibular Science

Diagnosis and Management of Vestibular Schwannoma: Focus on Dizziness: Sung Il Nam; Res Vestib Sci. 2021;20(4):119-125. Published online December 15, 2021; DOI: https://doi.org/10.21790/rvs.2021.20.4.119

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Vestibular schwannoma (VS) is commonly encountered in the cerebellopontine angle and benign neoplasms that arise from Schwann cells of the eighth cranial nerve, which can show not only hearing loss but also various vestibular symptoms. Dizziness is the symptom causing significantly negative effect on quality of life in patients with VS. Here, we will review the dizziness in VS.

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Impairment of Vestibular Function in Patients with Vestibular Schwannoma According to the Presence of Dizziness
Youngjeong Lee, Se A Lee, Eek-Sung Lee, Tae-Kyeong Lee, Jong Dae Lee
Research in Vestibular Science.2022; 21(3): 75. CrossRef

Long-Term Results of CyberKnife Radiosurgery for Vestibular Schwannoma: Ho Joong Lee, Chae Dong Yim, Hyun Woo Park, Dong Gu Hur, Ho Jin Jeong, Seong-Ki Ahn; Res Vestib Sci. 2017;16(1):23-28. Published online March 15, 2017; DOI: https://doi.org/10.21790/rvs.2017.16.1.23

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Abstract PDF: Objective: Since the 2000s, CyberKnife radiosurgery (CKRS) is either a primary or an adjunct management approach used to treat patients with vestibular schwannoma (VS). The goals of CKRS are prevention of tumor growth, preservation of cranial nerve function and prevention of new neurologic deficiencies. The aim of this study was to assess the efficacy and safety of CKRS, in terms of tumor control, hearing preservation, and complications.
Methods
Forty patients with VS underwent CKRS as a treatment modality for from January 2010 to February 2016. The long term results of 32 patients were evaluated who received CKRS as primary treatment. 8 patients presented with previously performed surgical resection. Information related to clinical history, Brain MRI and outcomes of patients with VS collected retrospectively by reviewing patient’s chart and telephone survey.
Results
The mean tumor volume was 3.3 cm³ and the mean follow-up was 41 months. The most recent follow-up showed that tumor size decreased in 17 patients (42.5%), displayed no change in 19 patients (47.5%), and increased in 4 patients (10%). Progression-free survival rates after CKRS at 1, 3, and 5 years were 95%, 90%, and 90%. After CKRS, 13 patients experienced hearing degradation. The overall rate of preservation of serviceable hearing at the long-term follow-up was 60%. Vertigo, ataxia, and headache were improved after CKRS compared with pretreated status. But, facial weakness, trigeminal nerve neuropathy, and tinnitus were worsen.
Conclusion
CKRS provide an excellent tumor control rate and a comparable hearing preservation rate in VS patients. Also CKRS is associated with low rate of cranial neuropathy, other complications.

Asymmetric Audiovestibular Dysfunction in Patients With Systemic Aminoglycoside Treatment: Jae Hong Park, Yoon Chan Rah, Ji Soo Kim, Ja Won Koo; Res Vestib Sci. 2013;12(2):62-66.

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Abstract: Since the characteristics of aminoglycoside ototoxicity is typically bilaterally symmetric progression of cochlea-vestibular dysfunction, a unilateral involvement has rarely been reported. However, ototoxicity can be asymmetric or focal after systemic aminoglycoside treatment. The authors report 2 cases of asymmetric or focal audiovestibular deficits in patients treated with systemic aminoglycoside. In such cases, further investigations are also necessary to rule out other possible causes of unilateral sensorineural hearing loss such as cerebellopontine angle tumors.

A Case of Vestibular Schwannoma Mimicking Acute Labyrinthitis: Dong Yeol Han, Won Ik Jang, Jong Dae Lee; Res Vestib Sci. 2009;8(2):164-167.

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Abstract PDF: Acute labyrinthitis is clinically characterized by cochlear symptom like sudden hearing loss, tinnitus and aural fullness and vestibular symptom like vertigo and spontaneous nystagmus. Several disease entities may mimic labyrinthitis when the disease does not manifest its own characteristic findings. We present the case of a 43-year-old female patient who was suffering from the acute vertigo and sudden hearing loss in her right ear. The speech discrimination score in right side was 24% and brain magnetic resonance imagine revealed a mass in internal auditory canal and minimally extending cerebellopontine angle. Removal of mass was performed via translabyrinthine approach and rapid vestibular compensation was accomplished after surgery.

A Case of inferior vestibular schwannoma which was lately diagnosed due to normal hearing level: Chang Jae Choi, Hyung Jin Chun, Hak Chun Lee, Sung Won Chae; J Korean Bal Soc. 2008;7(2):213-217.

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Abstract PDF: Vestibular schwannoma is a benign tumor arising from the Schwann cells in the vestibular nerve. It causes unilateral hearing loss, tinnitus, vertigo and unsteadiness. The most common symptom is reduced hearing on the affected side. In most cases patients present complaining of hearing impairment or vertigo from which the otologist can get a clue to diagnose vestibular schwannoma. We experienced an unusual case of 45-year-old woman presented with recurrent mild dizziness without any hearing loss so the patient initially diagnosed with recurrent vestibulopathy. However, subsequent neurotologic evaluation and posterior fossa MRI scanning confirmed diagnosis of huge vestibular schwannoma originated from inferior vestibular nerve. Key words: Vestibular schwannoma, Dizziness, Hearing loss, Auditory brainstem response

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