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The prediction of the tumor size of a vestibular schwannoma by clinical performance and vestibular function tests

Journal of Neuro-Oncology volume 140, pages 679–686 (2018)Cite this article

Abstract

Purpose

To investigate the relationship between vestibular schwannoma (VS) size and the dysfunction and compensation of the vestibular system.

Methods

One hundred fifty-two patients with unilateral VS were investigated using multiple auditory-vestibular function tests such as audiometry, sensory organization test (SOT), caloric test, cervical vestibular-evoked myogenic potential (cVEMP) test, and ocular VEMP (oVEMP) test.

Results

In this study, 89% of patients with unilateral VS had mild to severe hearing loss on the involved side. All patients showed higher threshold values or no response in the cVEMP and oVEMP tests, which both exhibited a lower response rate on the affected side than on the unaffected side. Patients with a tumor size ≥ 30 mm had significantly lower equilibrium scores for condition 5 and condition 6 of the SOT, which were associated with vestibular dysfunction, higher rates of canal paresis in the caloric test, and lower response rates in the cVEMP and oVEMP tests on the affected sides, compared with the results of patients with a tumor size ≤ 14 mm and patients with a tumor size of 15–29 mm.

Conclusions

A diameter > 30 mm may be the critical threshold at which vestibular function is affected and vestibular compensation is interfered with by a VS tumor. Functional performance of the vestibular system can help clinicians predict the size of a tumor and provide a basis for the development of treatment protocols.

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Acknowledgements

This project has received funding from National Nature Science Foundation of China (Grant No. 81200739) and Training Program of Outstanding Academic Leaders of Shanghai Municipal Commission of Health and Family Planning (Grant No. 2017BR057).

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Author notes

  1. Yujuan Zhou, Weidong Zhao and Liang Tian have contributed equally to the article.

Affiliations

  1. Department of Otology and Skull Base Surgery, Eye Ear Nose & Throat Hospital, Fudan University, Shanghai, People’s Republic of China

    Yujuan Zhou, Weidong Zhao, Liang Tian, Jing Yu, Yasheng Yuan & Jing Wang

  2. NHC Key Laboratory of Hearing Medicine (Fudan University), Shanghai, 200031, People’s Republic of China

    Yujuan Zhou, Weidong Zhao, Liang Tian, Jing Yu, Yasheng Yuan & Jing Wang

Authors
  1. Yujuan Zhou
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  2. Weidong Zhao
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  3. Liang Tian
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  4. Jing Yu
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  5. Yasheng Yuan
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  6. Jing Wang
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Corresponding authors

Correspondence to Yasheng Yuan or Jing Wang.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This study was approved by the institutional review board of EENT Hospital, Fudan University, Shanghai, China.

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Zhou, Y., Zhao, W., Tian, L. et al. The prediction of the tumor size of a vestibular schwannoma by clinical performance and vestibular function tests. J Neurooncol 140, 679–686 (2018). https://doi.org/10.1007/s11060-018-2998-y

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  • DOI: https://doi.org/10.1007/s11060-018-2998-y

Keywords

  • Vestibular schwannoma
  • Sensory organization test
  • Caloric test
  • Vestibular-evoked myogenic potential