Audiological correlates of tumor parameters in acoustic neuromas

Tutar, Hakan; Düzlü, Mehmet; Göksu, Nebil; Üstün, Selin; Bayazıt, Yıldırım A.

doi:10.1007/s00405-012-1954-2

Cited by 16 publications

(10 citation statements)

References 16 publications

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“… 36 The determination of tumor growth has mostly depended on brain imaging, since the tests that were previously adopted for evaluating audiovestibular function were found to be of limited use for monitoring the growth of a vestibular schwannoma. 37 38 In contrast, the head impulse VOR gains, both the ipsilesional and contralesional ones, were strongly correlated with the size of CPA tumors in the present study. Thus, HITs may play an important role in predicting tumor growth and reducing the number of costly brain scans when following up patients with CPA tumors.…”

Section: Discussioncontrasting

confidence: 68%

Bilaterally Abnormal Head Impulse Tests Indicate a Large Cerebellopontine Angle Tumor

Kim

Koo

et al. 2016

J Clin Neurol

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Background and PurposeTumors involving the cerebellopontine angle (CPA) pose a diagnostic challenge due to their diverse manifestations. Head impulse tests (HITs) have been used to evaluate vestibular function, but few studies have explored the head impulse gain of the vestibulo-ocular reflex (VOR) in patients with a vestibular schwannoma. This study tested whether the head impulse gain of the VOR is an indicator of the size of a unilateral CPA tumor.MethodsTwenty-eight patients (21 women; age=64±12 years, mean±SD) with a unilateral CPA tumor underwent a recording of the HITs using a magnetic search coil technique. Patients were classified into non-compressing (T1-T3) and compressing (T4) groups according to the Hannover classification.ResultsMost (23/28, 82%) of the patients showed abnormal HITs for the semicircular canals on the lesion side. The bilateral abnormality in HITs was more common in the compressing group than the non-compressing group (80% vs. 8%, Pearson's chi-square test: p<0.001). The tumor size was inversely correlated with the head impulse gain of the VOR in either direction.ConclusionsBilaterally abnormal HITs indicate that a patient has a large unilateral CPA tumor. The abnormal HITs in the contralesional direction may be explained either by adaptation or by compression and resultant dysfunction of the cerebellar and brainstem structures. The serial evaluation of HITs may provide information on tumor growth, and thereby reduce the number of costly brain scans required when following up patients with CPA tumors.

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Section: Discussioncontrasting

confidence: 68%

Bilaterally Abnormal Head Impulse Tests Indicate a Large Cerebellopontine Angle Tumor

Kim

Koo

et al. 2016

J Clin Neurol

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“…Audiological tests including audiometry and auditory brainstem response are not reliable predictors of CPA pathology (10). As most patients with CPA tumors have a comparable set of symptoms and audiometric results, the diagnosis relies mainly on imaging.…”

Section: Introductionmentioning

confidence: 99%

Biomarkers in Vestibular Schwannoma–Associated Hearing Loss

et al. 2019

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Vestibular schwannomas (VSs) are benign tumors composed of differentiated neoplastic Schwann cells. They can be classified into two groups: sporadic VS and those associated with neurofibromatosis type 2 (NF2). VSs usually grow slowly, initially causing unilateral sensorineural hearing loss (HL) and tinnitus. These tumors cause HL both due to compression of the auditory nerve or the labyrinthine artery and due to the secretion of different substances potentially toxic to the inner ear or the cochlear nerve. As more and more patients are diagnosed and need to be managed, we are more than ever in need of searching for biomarkers associated with these tumors. Owing to an unknown toxic substance generated by the tumor, HL in VS may be linked to a high protein amount of perilymph. Previous studies have identified perilymph proteins correlated with tumor-associated HL, including μ-Crystallin (CRYM), low density lipoprotein receptor-related protein 2 (LRP2), immunoglobulin (Ig) γ-4 chain C region, Ig κ-chain C region, complement C3, and immunoglobulin heavy constant γ 3. Besides, the presence of specific subtypes of heat shock protein 70 has been suggested to be associated with preservation of residual hearing. It has been recently demonstrated that chemokine receptor-4 (CXCR4) is overexpressed in sporadic VS as well as in NF2 tumors and that hearing disability and CXCR4 expression may be correlated. Further, the genetic profile of VS and its relationship with poor hearing has also been studied, including DNA methylation, deregulated genes, growth factors, and NF2 gene mutations. The knowledge of biomarkers associated with VS would be of significant value to maximize outcomes of hearing preservation in these patients.

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“…The most frequent hearing finding in pure tone audiometry for VS in humans is a high frequency sensorineural hearing loss [7,8,41]. Animal models cannot precisely recapitulate hearing loss in humans since other mammalians do not share our unique auditory sensitivity [42].…”

Section: Discussionmentioning

confidence: 99%

“…The NF2 tumor suppressor gene [3,4], is inactivated in both NF2-associated and sporadic VS [5,6]. At presentation, more than 90 % of NF2 patients demonstrate some change in hearing on the side of a VS [7], with the usual audiogram describing a high-frequency slope in more than 60 % [7,8].…”

Section: Introductionmentioning

confidence: 99%