Skip to main content
SpringerLink
Log in

Evaluation of Vestibular Function in Diagnosis of Vestibular Schwannomas

  • Published:
Current Medical Science Aims and scope Submit manuscript

Abstract

Vestibular schwannomas (VS) are benign tumors of the vestibular nerve. The common first symptoms are hearing loss and tinnitus, followed by imbalance, vertigo, and facial nerve involvement. The subjective symptoms of VS patients are not consistent with the severity of vestibular lesions and the results of vestibular tests, which often interfere with clinicians’ diagnoses. Thus, the main screening and diagnostic methods for VS are audiometry and magnetic resonance imaging (MRI), ignoring the evaluation of vestibular function at the source of pathological lesions. With the development and improvement of vestibular evaluation technology and its wide application in the clinic, modern vestibular examination technology can reflect the severity and frequency of vestibular lesions and compensation from multiple perspectives, providing an objective basis for the diagnosis and treatment of vestibular diseases. In this report, we review the results and characteristics of vestibular tests in VS patients and further clarify the clinical value of vestibular function assessment in the diagnosis and treatment of VS.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. St Martin MB, Hirsch BE. Imaging of hearing loss. Otolaryngol Clin North Am, 2008,41(1):157–178

    Article  PubMed  Google Scholar 

  2. Lin D, Hegarty JL, Fischbein NJ, et al. The prevalence of “incidental” acoustic neuroma. Arch Otolaryngol Head Neck Surg, 2005,131(3):241–244

    Article  PubMed  Google Scholar 

  3. Morcos JJ. Vestibular schwannomas. J Neurosurg, 2013, 118(3):550–553

    Article  PubMed  Google Scholar 

  4. Propp JM, McCarthy BJ, Davis FG, et al. Descriptive epidemiology of vestibular schwannomas. Neuro Oncol, 2006,8(1):1–11

    Article  PubMed  PubMed Central  Google Scholar 

  5. Pandrangi VC, Han AY, Alonso JE, et al. An Update on Epidemiology and Management Trends of Vestibular Schwannomas. Otol Neurotol, 2020,41(3):411–417

    Article  PubMed  Google Scholar 

  6. Kentala E, Pyykko I. Clinical picture of vestibular schwannoma. Auris Nasus Larynx, 2001,28(1):15–22

    Article  CAS  PubMed  Google Scholar 

  7. Goldbrunner R, Weller M, Regis J, et al. EANO guideline on the diagnosis and treatment of vestibular schwannoma. Neuro Oncol, 2020,22(1):31–45

    Article  PubMed  Google Scholar 

  8. Andersen JF, Nilsen KS, Vassbotn FS, et al. Predictors of vertigo in patients with untreated vestibular schwannoma. Otol Neurotol, 2015,36(4):647–652

    Article  PubMed  Google Scholar 

  9. Nam GS, Jung CM, Kim JH, et al. Relationship of Vertigo and Postural Instability in Patients With Vestibular Schwannoma. Clin Exp Otorhinolaryngol, 2018,11(2):102–108

    Article  PubMed  PubMed Central  Google Scholar 

  10. Welling DB, Glasscock ME, Woods CI, et al. Acoustic neuroma: a cost-effective approach. Otolaryngol Head Neck Surg, 1990,103(3):364–370

    Article  CAS  PubMed  Google Scholar 

  11. Charabi S. Acoustic neuroma/vestibular schwannoma in vivo and in vitro growth models. A clinical and experimental study. Acta Otolaryngol Suppl, 1997,530: 1–27

    CAS  PubMed  Google Scholar 

  12. Day AS, Wang CT, Chen CN, et al. Correlating the cochleovestibular deficits with tumor size of acoustic neuroma. Acta Otolaryngol, 2008,128(7):756–760

    Article  PubMed  Google Scholar 

  13. Gouveris H, Akkafa S, Lippold R, et al. Influence of nerve of origin and tumor size of vestibular schwannoma on dynamic posturography findings. Acta Otolaryngol, 2006,126(12):1281–1285

    Article  PubMed  Google Scholar 

  14. Hoffmann CP, Seigle B, Frere J, et al. Dynamical analysis of balance in vestibular schwannoma patients. Gait Posture, 2017,54:236–241

    Article  PubMed  Google Scholar 

  15. von Kirschbaum C, Gurkov R. Audiovestibular Function Deficits in Vestibular Schwannoma. Biomed Res Int, 2016,2016:4980562

    Article  PubMed  PubMed Central  Google Scholar 

  16. Stipkovits EM, Van Dijk JE, Graamans K. Electronystagmographic changes in patients with unilateral vestibular schwannomas in relation to tumor progression and central compensation. Eur Arch Otorhinolaryngol, 1999,256(4):173–176

    Article  CAS  PubMed  Google Scholar 

  17. West N, Sass H, Klokker M, et al. Video Head Impulse Test Results in Patients With a Vestibular Schwannoma-Sensitivity and Correlation With Other Vestibular System Function Tests, Hearing Acuity, and Tumor Size. Otol Neurotol, 2020,41(5):e623–e629

    Article  PubMed  Google Scholar 

  18. Tringali S, Charpiot A, Ould MB, et al. Characteristics of 629 vestibular schwannomas according to preoperative caloric responses. Otol Neurotol, 2010,31(3):467–472.

    Article  PubMed  Google Scholar 

  19. Blodow A, Helbig R, Wichmann N, et al. The video head impulse test: first clinical experiences. HNO, 2013,61(4):327–334.

    CAS  PubMed  Google Scholar 

  20. Hebb ALO, Erjavec N, Morris DP, et al. Quality of life related to symptomatic outcomes in patients with vestibular schwannomas: A Canadian Centre perspective. Am J Otolaryngol, 2019,40(2):236–246

    Article  PubMed  Google Scholar 

  21. Kim HJ, Park SH, Kim JS, et al. Bilaterally Abnormal Head Impulse Tests Indicate a Large Cerebellopontine Angle Tumor. J Clin Neurol, 2016,12(1):65–74

    Article  PubMed  Google Scholar 

  22. Borgmann H, Lenarz T, Lenarz M. Preoperative prediction of vestibular schwannoma’s nerve of origin with posturography and electronystagmography. Acta Otolaryngol, 2011,131(5):498–503

    Article  PubMed  Google Scholar 

  23. Ushio M, Iwasaki S, Chihara Y, et al. Is the nerve origin of the vestibular schwannoma correlated with vestibular evoked myogenic potential, caloric test, and auditory brainstem response? Acta Otolaryngol, 2009,129(10):1095–1100

    Article  PubMed  Google Scholar 

  24. Wagner JN, Glaser M, Wowra B, et al. Vestibular function and quality of life in vestibular schwannoma: does size matter? Front Neurol, 2011,2:55

    Article  PubMed  PubMed Central  Google Scholar 

  25. Teggi R, Franzin A, Spatola G, et al. Vestibular assessment in patients with vestibular schwannomas: what really matters? Acta Otorhinolaryngologica Italica Organo Ufficiale Della Società Italiana Di Otorinolaringologia E Chirurgia Cervico Facciale, 2014, 34(2):123–128

    CAS  PubMed  PubMed Central  Google Scholar 

  26. Stidham KR, Roberson JB. Hearing improvement after middle fossa resection of vestibular schwannoma. Otology & Neurotology, 2001,22(6):917–921

    Article  CAS  Google Scholar 

  27. Bloching, Boris M, Bloedow, et al. Horizontal VOR function shows frequency dynamics in vestibular schwannoma. European archives of oto-rhino-laryngology: Official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS), 2015

  28. Constanzo F, Sens P, Teixeira BCA, et al. Video Head Impulse Test to Preoperatively Identify the Nerve of Origin of Vestibular Schwannomas. Oper Neurosurg (Hagerstown), 2019,16(3):319–325

    Article  Google Scholar 

  29. Jorns-Haderli M, Straumann D, Palla A. Accuracy of the bedside head impulse test in detecting vestibular hypofunction. J Neurol Neurosurg Psychiatry, 2007, 78(10):1113–1118

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  30. Halmagyi GM, Curthoys IS, Cremer PD, et al. The human horizontal vestibulo-ocular reflex in response to high-acceleration stimulation before and after unilateral vestibular neurectomy. Exp Brain Res, 1990,81(3):479–490

    Article  CAS  PubMed  Google Scholar 

  31. O’Leary DP, Davis LL. High-frequency auorotational testing of the vestibuloocular reflex. Neurologic Clinics, 1990,8(2):297–312

    Article  PubMed  Google Scholar 

  32. Hirvonen TP, Pyykko I, Aalto H, et al. Vestibulo-ocular reflex function as measured with the head autorotation test. Acta Otolaryngol, 1997,117(5):657–662

    Article  CAS  PubMed  Google Scholar 

  33. Yan T, Zong F, Han X, et al. Vestibular Neuritis in Patients Among Different Age Groups: Clinical Features and Outcomes. J Am Acad Audiol, 2020,31(9):629–635

    Article  PubMed  PubMed Central  Google Scholar 

  34. Rosengren SM, Welgampola MS, Colebatch JG. Vestibular evoked myogenic potentials: past, present and future. Clin Neurophysiol, 2010,121(5):636–651

    Article  CAS  PubMed  Google Scholar 

  35. Kantner C, Gurkov R. Characteristics and clinical applications of ocular vestibular evoked myogenic potentials. Hear Res, 2012,294(1–2):55–63

    Article  CAS  PubMed  Google Scholar 

  36. Adamec I, Skoric MK, Handzic J, et al. The role of cervical and ocular vestibular-evoked myogenic potentials in the follow-up of vestibular neuritis. Clin EEG Neurosci, 2014,45(2):129–136

    Article  PubMed  Google Scholar 

  37. Iwasaki S, Murofushi T, Chihara Y, et al. Ocular vestibular evoked myogenic potentials to bone-conducted vibration in vestibular schwannomas. Otol Neurotol, 2010,31(1):147–152

    Article  PubMed  Google Scholar 

  38. Church S, Murofushi T, Chihara Y, et al. Endocarditis caused by Pasteurella caballi in a horse. Aust Vet J, 1998,76(8):528–530

    Article  CAS  PubMed  Google Scholar 

  39. Ushio M, Matsuzaki M, Takegoshi H, et al. Click- and short tone burst-evoked myogenic potentials in cerebellopontine angle tumors. Acta Otolaryngol Suppl, 2001,545:133–135

    CAS  PubMed  Google Scholar 

  40. Hu YF, Cheng PW, Young YH. Comparison of vestibular function between large cerebellopontine angle meningioma and schwannoma. Acta Otolaryngol, 2009,129(2):161–165

    Article  PubMed  Google Scholar 

  41. Gouveris H, Helling K, Victor A, et al. Comparison of electronystagmography results with dynamic posturography findings in patients with vestibular schwannoma. Acta Otolaryngol, 2007,127(8):839–842

    Article  PubMed  Google Scholar 

  42. Gouveris H, Stripf T, Victor A, et al. Dynamic posturography findings predict balance status in vestibular schwannoma patients. Otology & Neurotology, 2007,28(3):372–375

    Article  Google Scholar 

  43. Ribeyre L, Frere J, Gauchard G, et al. Preoperative balance control compensation in patients with a vestibular schwannoma: does tumor size matter? Clin Neurophysiol, 2015,126(4):787–793

    Article  PubMed  Google Scholar 

  44. Yin M, Ishikawa K, Omi E, et al. Small vestibular schwannomas can cause gait instability. Gait Posture, 2011,34(1):25–28

    Article  CAS  PubMed  Google Scholar 

  45. Pagarkar W, Bamiou DE, Ridout D, et al. Subjective visual vertical and horizontal: effect of the preset angle. Arch Otolaryngol Head Neck Surg, 2008,134(4):394–401

    Article  PubMed  Google Scholar 

  46. Zhao Y, Chen T, Wang W, et al. The application of subjective visual gravity in assessment of vestibular compensation: a pilot study. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi, 2016, 51(5):355–360

    PubMed  Google Scholar 

  47. Cada Z, Balatkova Z, Cakrt O, et al. Predictors of central vestibular compensation after surgery for vestibular schwannomas. Acta Otorhinolaryngol Ital, 2019,39(1):46–52

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  48. Thomeer H, Bonnard D, Franco-Vidal V, et al. Prognostic Factors of Balance Quality After Transpetrosal Vestibular Schwannoma Microsurgery: An Instrumentally and DHI-based Prospective Cohort Study of 48 Patients. Otol Neurotol, 2015,36(5):886–891

    Article  PubMed  Google Scholar 

  49. Furman JM, Balaban CD, Pollack IF. Vestibular compensation in a patient with a cerebellar infarction. Neurology, 1997,48(4):916–920

    Article  CAS  PubMed  Google Scholar 

  50. Breivik CN, Nilsen RM, Myrseth E, et al. Working disability in Norwegian patients with vestibular schwannoma: vertigo predicts future dependence. World Neurosurg, 2013,80(6):e301–e305

    Article  PubMed  Google Scholar 

  51. Dayal M, Perez-Andujar A, Chuang C, et al. Management of vestibular schwannoma: focus on vertigo. CNS Oncol, 2013,2(1):99–104

    Article  CAS  PubMed  Google Scholar 

  52. 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, 2018,140(3):679–686

    Article  PubMed  Google Scholar 

  53. Halliday J, Rutherford SA, McCabe MG, et al. An update on the diagnosis and treatment of vestibular schwannoma. Expert Rev Neurother, 2018,18(1):29–39

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Otorhinolaryngology Head and Neck Surgery, Tianjin First Central Hospital, Tianjin, 300192, China

    Xue-qing Zhang, Tai-sheng Chen & Wei Wang

  2. Institute of Otolaryngology of Tianjin, Tianjin, 300192, China

    Xue-qing Zhang, Tai-sheng Chen & Wei Wang

  3. Key Laboratory of Auditory Speech and Balance Medicine, Tianjin, 300192, China

    Xue-qing Zhang, Tai-sheng Chen & Wei Wang

  4. Key Clinical Discipline of Tianjin (Otolaryngology), Tianjin, 300192, China

    Xue-qing Zhang, Tai-sheng Chen & Wei Wang

  5. Otolaryngology Clinical Quality Control Centre, Tianjin, 300192, China

    Xue-qing Zhang, Tai-sheng Chen & Wei Wang

Authors
  1. Xue-qing Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Tai-sheng Chen
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Wei Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Wei Wang.

Ethics declarations

All authors declare no conflicts of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Zhang, Xq., Chen, Ts. & Wang, W. Evaluation of Vestibular Function in Diagnosis of Vestibular Schwannomas. CURR MED SCI 41, 661–666 (2021). https://doi.org/10.1007/s11596-021-2407-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11596-021-2407-1

Key words

Search

Navigation