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Vestibular schwannoma: when to look for it?

Published online by Cambridge University Press:  19 November 2009

S Gimsing
S Gimsing*
Affiliation:
Department of Audiology, Vejle Hospital, Denmark
*
Address for correspondence: Dr Steen Gimsing, Department of Audiology, Vejle Hospital, DK-7100Denmark. E-mail: [email protected]
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Abstract

Objectives:

(1) To compare audiometric parameters in patients with vestibular schwannoma and in those with asymmetric hearing loss from other causes; and (2) to assess proposed screening criteria by comparing published protocols.

Methods:

Audiometric data from 199 vestibular schwannoma patients and 225 non-tumour patients were compared. Eight screening protocols were tested on these 424 patients.

Results:

Vestibular schwannoma and non-tumour patients with little or no hearing loss in the unaffected ear were inseparable; however, vestibular schwannoma patients with hearing loss in the unaffected ear had greater audiometric asymmetry, compared with non-tumour patients with the same pattern of hearing loss. The sensitivity of screening protocols varied from 73 to 100 per cent; parallelism was observed between sensitivity and screening rate.

Conclusion:

As regards vestibular schwannoma screening protocols, the best compromise between sensitivity and screening rate was offered by a criterion comprising either: (1) ≥20 dB asymmetry at two neighbouring frequencies, or unilateral tinnitus, or (2) ≥15 dB asymmetry at two frequencies between 2 and 8 kHz.

Keywords

Acoustic NeuromaScreeningMagnetic Resonance Imaging
Type
Main Article
Information
The Journal of Laryngology & Otology , Volume 124 , Issue 3 , March 2010 , pp. 258 - 264
Copyright
Copyright © JLO (1984) Limited 2009

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References

1Tos, M, Stangerup, SE, Cayé-Thomasen, P, Tos, T, Thomsen, J. What is the real incidence of vestibular schwannoma? Arch Otolaryngol Head Neck Surg 2004;130:216–20CrossRefGoogle ScholarPubMed
2Stangerup, SE, Cayé-Thomasen, P, Tos, M, Thomsen, J. The natural history of vestibular schwannoma. Otol Neurotol 2006;27:547–52CrossRefGoogle ScholarPubMed
3Dawes, PJD, Jeannon, JP. Audit of regional screening guidelines for vestibular schwannoma. J Laryngol Otol 1998;112:860–4CrossRefGoogle ScholarPubMed
4Sheppard, IJ, Milford, CAM, Anslow, P. MRI in the detection of acoustic neuromas – a suggested protocol for screening. Clin Otolaryngol 1996;21:301–4CrossRefGoogle ScholarPubMed
5Moffat, DA, Baguley, DM, Beynon, GJ, Da Cruz, M. Clinical acumen and vestibular schwannoma. Am J Otol 1998;19:82–7Google ScholarPubMed
6Hunter, L, Ries, DT, Schlauch, RS, Levine, SC, Ward, DW. Safety and clinical performance of acoustic reflex tests. Ear Hear 1999;20:506–14CrossRefGoogle ScholarPubMed
7Mangham, CA. Hearing threshold difference between ears and risk of acoustic tumor. Otolaryngol Head Neck Surg 1991;105:814–17CrossRefGoogle ScholarPubMed
8Obholzer, RJ, Rea, PA, Harcourt, JP. Magnetic resonance imaging screening for vestibular schwannoma: analysis of published protocols. J Laryngol Otol 2004;118:329–32CrossRefGoogle ScholarPubMed
9Schlauch, RS, Levine, S. Evaluating hearing threshold differences between ears as a screen for acoustic neuroma. J Speech Hear Res 1995;38:1168–75CrossRefGoogle ScholarPubMed
10Nouraei, SAR, Huys, QJM, Chatrath, P, Powles, J, Harcourt, JP. Screening patients with sensorineural hearing loss for vestibular schwannoma using a bayesian classifier. Clin Otolaryngol 2007;32:248–54CrossRefGoogle ScholarPubMed
11Welling, DB, Glasscock, ME, Woods, CI, Jackson, CG. Acoustic neuroma: a cost-effective approach. Otolaryngol Head Neck Surg 1990;103:364–70CrossRefGoogle ScholarPubMed
12Kanzaki, J, Tos, M, Sanna, M, Moffat, DA. New and modified reporting system from the consensus meeting on systems for reporting results in vestibular schwannoma. Otol Neurotol 2003;24:642–9CrossRefGoogle ScholarPubMed
13Elberling, C, Ludvigsen, C, Lyregaard, PE. Dantale: a new Danish speech material. Scand Audiol 1989;18:169–75CrossRefGoogle ScholarPubMed
14Neary, WJ, Newton, VE, Laoide-Kemp, SN, Ramsden, RT, Hillier, VF, Kan, SW. A clinical, genetic and audiological study of patients and families with unilateral vestibular schwannomas. II. Audiological findings in 93 patients with unilateral vestibular schwannomas. J Laryngol Otol 1996;110:1120–8CrossRefGoogle ScholarPubMed
15Lönn, S, Ahlbom, A, Hall, P, Feychting, M. Mobile phone use and risk of acoustic neuroma. Epidemiology 2004;15:653–9CrossRefGoogle ScholarPubMed
16Thomsen, J, Terkildsen, K, Tos, M. Acoustic neuromas. Progression of hearing impairment and function of the eighth cranial nerve. Am J Otol 1983;5:20–33Google ScholarPubMed
17Auditdata. In:http://www.auditdata.com/Audit [21.9.2009]Google Scholar