Red flags alerting a posterior cranial fossa tumor from audiovestibular perspectives - a review

Abstract

Background

There is no comprehensive and up-to-date overview of audiovestibular approach to the posterior fossa tumors in the literature.

Objective

This paper reviewed the literature relating to tumors at the posterior cranial fossa to find red flags alerting a posterior fossa lesion from audiovestibular perspectives.

Methods

This review was developed from articles published in those journals listed on the journal citation reports. Through the PubMed database, Embase, Google Scholar, and Cochrane library, 60 articles were finally obtained based on the PRISMA guidelines for reporting reviews.

Results

The presence of one red flag indicates a positive predictive value of 33% for detecting a posterior fossa lesion. Clinical features, namely, 1) mid-frequency sudden sensorineural hearing loss (SNHL), 2) bilateral sudden SNHL, and 3) rebound nystagmus may indicate a posterior fossa lesion, representing one, two, and three red flags, respectively.

Conclusion

Those with 1) mid-frequency sudden SNHL, 2) bilateral sudden SNHL, and 3) rebound nystagmus trigger one, two, and three red flags, respectively, alerting clinicians the possibility of a posterior fossa lesion, which warrant MR imaging to exclude life-threatening or treatable conditions.

Significance

Patients with posterior fossa tumors may have potential life-threatening outcome.

Chinese Abstract

背景：目前在文献中还没有关于治疗后颅窝肿瘤的前庭听力功能法的全面且最新的介绍。

目的：回顾后颅窝肿瘤相关文献, 寻找从前庭听力角度警示后颅窝病变的标志。

方法：这篇综述是根据在引用报告志上列出的那些期刊上发表的文章编写的。 通过 PubMed 数据库、Embase、Google Scholar 和 Cochrane 图书馆, 最终根据PRISMA报告评论指南获得60篇文章。

结果：一个危险信号的出现表示检测后颅窝病变的阳性预测值为 33%。 临床特征, 即1）中频突发感音神经性耳聋(SNHL), 2) 双侧突发性 SNHL, 以及 3) 反弹性眼球震颤可能表示后颅窝病变, 它们分别代表一个、两个和三个危险信号。

结论：患有 1) 中频突发 SNHL、2) 双侧突发 SNHL 和 3) 反弹性眼球震颤的患者分别触发一个、两个和三个危险信号, 提醒临床医生可能发生后颅窝病变, 需要进行 MR 成像以排除危及生命或可治疗的疾病。

意义：后颅窝肿瘤患者可能面对潜在的危及生命的结果。

Keywords:

• acoustic neuroma
• cerebellopontine angle tumor
• meningioma
• stereotactic radiosurgery
• vestibular schwannoma

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This study was supported by National Science Council, Taipei, Taiwan (Grant no. NSTC 112-2314-B418-003) and Far Eastern Memorial Hospital (Grant no. FEMH 112-2314-B418-003).