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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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