Constanzo F, Teixeira BCDA, Sens P, Ramina R. Video Head Impulse Test in Vestibular Schwannoma: Relevance of Size and Cystic Component on Vestibular Impairment.
Otol Neurotol 2020;
40:511-516. [PMID:
30870368 DOI:
10.1097/mao.0000000000002158]
[Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES
Tumor factors that influence vestibular function in vestibular schwannoma (VS) have not been properly described. We evaluated whether cystic VSs have different vestibular function than solid VS. Tumor size on vestibular function was also evaluated.
STUDY DESIGN
Cross-sectional study.
SETTING
Tertiary referral center.
PATIENTS
Forty-one cases of sporadic, untreated VS.
INTERVENTION
Evaluation with video head impulse test and MRI.
MAIN OUTCOME MEASURES
Tumors were classified as solid, heterogeneous, or cystic and by size using the Hannover classification. Vestibulo-ocular reflex (VOR) gain was correlated to tumor size and cystic status.
RESULTS
Large VS had worse VOR gain than small lesions (p < 0.001). Cystic lesions had lower VOR gain than all other tumors (p = 0.001), Hannover T3 and T4 (p = 0.014), Hannover T4 (p = 0.015), solid tumors (p < 0.001), solid Hannover T3 and T4 (p = 0.003), and solid Hannover T4 (p = 0.008). Heterogeneous VSs had lower VOR gain compared to solid tumors (p = 0.02), solid Hannover T3 and T4 (p = 0.08), and solid Hannover T4 (p = 0.14). Heterogeneous and cystic VSs had lower VOR gain than solid tumors (p < 0.001), solid Hannover T3 and T4 (p = 0.004), and solid Hannover T4 (p = 0.02). VOR gain of solid T4 lesions was not significantly lower than solid Hannover T1-T3 (p = 0.33).
CONCLUSION
Cystic status is directly associated with a worse vestibular dysfunction. Size did not significantly impact vestibular function in solid VS.
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