Research in Vestibular Science

Original Article

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; Res Vestib Sci. 2022;21(3):75-79. Published online September 15, 2022; DOI: https://doi.org/10.21790/rvs.2022.21.3.75

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Abstract PDF: Objectives
Vestibular schwannoma (VS) is a benign Schwann cell-derived slow growing tumor originating from the vestibular nerve. Here, we aimed to investigate the correlation between the presence of the dizziness symptoms and several vestibular function test results.
Methods
We analyzed 32 patients who diagnosed with VS from 2010 to 2021 in our hospital. Caloric test, cervical vestibular-evoked myogenic potential (cVEMP) test, and video head impulse test (vHIT) were analyzed.
Results
Age, sex, pure tone audiometry, and tumor size did not show any statistical significance according to the presence or absence of dizziness. There was also no association between the presence of dizziness symptom or dizziness type and the results of the caloric test, vHIT, and cVEMP test, respectively. However, patients with dizziness had a higher rate of tumors confined to the inner auditory canal than those without dizziness.
Conclusions
In this study, the rate of complaints of dizziness was higer in patients with intracanalicular VS. The diagnostic role of vestibulsr function tests in VS is limited. The dissociation of the results of caloric test, vHIT, and cVEMP test suggest that these test are complementary.

Case Reports

A Case of Recurrent Vertigo in Vestibular Schwannoma Treated with Chemical Labyrinthectomy: Seung Jae Lee, Eun Sang Lee, Bo Gyung Kim, Jong Dae Lee; Res Vestib Sci. 2017;16(4):147-150. Published online December 15, 2017; DOI: https://doi.org/10.21790/rvs.2017.16.4.147

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1 Crossref

Vestibular schwannoma (VS) can have various symptoms and almost half of the patients have balance problems. Some patients with VS can suffer from recurrent vertigo mimicking Meniere’s disease. We present the case of a 61-year-old male patient who was suffering from recurrent vertigo due to VS while symptoms improved by chemical labyrinthectomy with gentamicin. We consider that chemical labyrinthectomy can be an option in the treatment of patients with recurrent vertigo for VS.

Citations

Citations to this article as recorded by

Diagnosis and Management of Vestibular Schwannoma: Focus on Dizziness
Sung Il Nam
Research in Vestibular Science.2021; 20(4): 119. CrossRef

Recurrent Vertigo in Vestibular Schwannoma Responsive to Oxcarbazepine: Jae Hwan Choi, Min Ji Kim, Kwang Dong Choi, Dae Soo Jung; Res Vestib Sci. 2013;12(2):58-61.

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Abstract PDF: Vestibular schwannoma (VS) are benign neoplasms that arise from Schwann cells of the eighth cranial nerve. Although progressive unilateral hearing loss with dizziness or disequilibrium provides a high suspicion index of VS, vertigo is the symptom causing the most pronounced negative effect on quality of life in patients with VS. We report a 55-year-old woman with recurrent paroxysmal vertigo and hyperventilation-induced nystagmus due to VS, which improved by oxcarbazepine treatment. We suggest that episodic vertigo in VS may be ascribed to the ectopic paroxysmal neuronal discharge from the partially demyelinated vestibular nerve due to tumor compression.

Original Articles

Diagnostic Value of Vestibular Evoked Myogenic Potential in Acoustic Neuroma: Young Jin Ahn, Sung Kwang Hong, Ji Soo Kim, Ja Won Koo; J Korean Bal Soc. 2007;6(2):138-142.

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Abstract PDF: Background and Objectives: Considering vestibular evoked myogenic potential (VEMP) represents functional integration of the inferior vestibular nerve and large proportion of acoustic neuroma (AN) originate from inferior vestibular nerve, VEMP test may provide more valuable information than ABR and the caloric test in terms of evaluating functional integration as well as screening test. Authors hope to clarify such hypothesis and also analyzed if parameters differ between cochlear lesion and retrocochlear lesion. Materials and Methods: Authors analyzed the results of VEMP test in 27 patients (10 males and 17 females) of AN and in 24 patients (9 males and 15 females) of unilateral definite Meniere’s disease (MD). Right-left difference of interpeak latency (IPL) and interaural amplitude difference (IAD) were used as parameters of VEMP. Longest diameter of the enhanced area was measured as the size of tumor on the axial view of Gadolium enhanced T1 weighted magnetic resonance image. Results: VEMP was abolished in 15 out of 27 AN patients (54.5%). Among the remaining 12 patients, 1 patient showed increased IPL and IAD at same time, while 2 patients exhibited increased IAD. The mean diameter of tumor in the group who showed positive VEMP waves was significantly smaller (0.95 cm) than that of abolished VEMP group (2.22 cm)(p=0.004). Similar tendency was also present in ABR and Caloric test. However, there was not significant difference between MD and AN in the latencies and amplitudes. Conclusions: VEMP test may not provide diagnostic information in smaller AN, especially less than 1 cm. And parameters of VEMP were not differ between cochlear and retrocochlear lesion. However, VEMP response seems still important for the comprehensive understanding of peripheral cochleovestibular status in addition to ABR and caloric test.

Results of Vestibular Function Tests in Patients with Cerebello-Pontine Aangle Tumors: Hyang Ae Shin, Yong Soo Jeong, Jin Suk Yoo, HongJu Park; J Korean Bal Soc. 2006;5(2):253-261.

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Abstract PDF: Background
and Objectives: Acoustic neuroma (AN) is commonly encountered in the cerebello-pontine angle (CPA) and AN arises principally from the vestibular division of the nerve, which can show not only hearing disturbance but also various vestibular symptoms and laboratory findings by affecting central and peripheral vestibular system. Vestibular testing is reported not to be a useful screening test for AN, but can be helpful in defining whether the tumor arises from the superior or inferior division and identifying the cause of dizziness or vertigo. Materials and Method: We are presenting four patients with CPA tumors accompanied by various abnormal findings of vestibular function tests including head-shaking nystagmus, vibration-induced nystagmus, hyperventilation- induced nystagmus and vestibular evoked myogenic potential and subjective visual vertical, which can enable us to understand the pathomechanism of the abnormal results.
Results
All patients presented hearing loss and mild dizziness. Caloric test, head thrust test and vibration-induced nystagmus was helpful in localizing the disease, but head-shaking nystagmus and hyperventilation-induced nystagmus was less helpful. Otolith tests did not always show abnormal results.
Conclusion
We should consider abnormal results of the vestibular function tests in a whole to estimate the status of vestibular compensation in patients with CPA tumors. Key Words : Nystagmus, Subjective visual vertical, Acoustic neuroma

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