Vibration-induced nystagmus and head impulse test screening for vestibular schwannoma

Abstract

Level of evidence

II-2

Background

Vestibular schwannomas are benign tumors of the eight cranial nerve that may cause asymmetric sensorineural hearing loss (ASHL) and vestibular dysfunction.

Objective

The aim of this study was to assess the role of the video head impulse test (vHIT) and vibration-induced nystagmus (VIN) test in diagnosing vestibular schwannoma in a population of patients with Asymmetric sensorineural hearing loss.

Material and methods

For this prospective case-control study, 23 consecutive patients with ASHL and normal magnetic resonance were enrolled in the control group, and 33 consecutive patients with ASHL and vestibular schwannoma were enrolled in the case group. Gold standard was magnetic resonance imaging. Audiometry, vHIT, and VIN tests were performed for each patient. Significance of VIN and vHIT testing was determined by evaluation of their sensitivity, specificity, and correlation with vestibular function tests.

Results

Regarding the vHIT, sensitivity and specificity were 45.5% and 82.6%, respectively, for horizontal canal gain, 60.6% and 87.6%, respectively, for posterior canal gain, and 45.5% and 78.3%, respectively, when analyzing superior canal gains. Regarding the VIN test, the sensitivity and specificity were 81.8% and 73.9%, respectively, when based on the presence of a VIN with any mastoid stimulation.

Conclusions

Our results suggest that using the VIN test may be an efficient approach to screen for vestibular schwannoma in patients with asymmetric sensorineural hearing loss.

Significance

Our results suggest that using the VIN test may be an efficient approach to screen for vestibular schwannoma in patients with ASHL.

Chinese abstract

证据水平：II-2

背景：前庭神经鞘瘤是第八颅神经的良性肿瘤, 可能会引起不对称感觉神经性听力损失（ASHL）和前庭功能障碍。

目的：本研究旨在评估视频头冲测试（vHIT）和振动诱发的眼球震颤（VIN）测试在诊断不对称感觉神经性听力损失患者人群中的前庭神经鞘瘤的作用。

材料和方法：在这项前瞻性病例-对照研究中, 对照组共入选23例患ASHL且磁共振正常的连续患者, 病例组入选33例患ASHL和前庭神经鞘瘤的连续患者。金标准是磁共振成像。对每位患者进行了听力、vHIT和VIN测试。 VIN和vHIT检测的重要性通过评估其敏感性、特异性以及与前庭功能检测的相关性来确定。

结果：关于vHIT, 水平耳道增益的敏感性和特异性分别为45.5％和82.6％, 后耳道增益的敏感性和特异性分别为60.6％和87.6％, 而上耳道增益的敏感性和特异性分别为45.5％和78.3％ 。关于VIN测试, 当基于任何乳突刺激的VIN存在时, 敏感性和特异性分别为81.8％和73.9％。

结论：我们的结果表明, 使用VIN测试可能是筛查不对称感觉神经性听力损失患者前庭神经鞘瘤的有效方法。

意义：我们的结果表明, 使用VIN测试可能是筛查ASHL患者前庭神经鞘瘤的有效方法。

Keywords:

• Vibration-induced nystagmus
• video head impulse test
• vestibular schwannoma
• sensitivity
• screening

Disclosure statement

No potential conflict of interest was reported by the authors.