Identification of predictors and development of a screening protocol for cerebello‐pontine lesions in patients presenting with audio‐vestibular dysfunction

Abstract

We have identified audiometric factors which exert a positive and negative predictive influence on the presence of a cerebellopontine angle lesion, and audiovestibular symptoms which appear to exert little effect on the model. Our predictive equation represents a user-friendly standardised method of risk-stratification of patients within a general otolaryngology clinic.

The diagnostic accuracy of non‐imaging screening protocols for vestibular schwannoma in patients with asymmetrical hearing loss and/or unilateral audiovestibular dysfunction: a diagnostic review and meta‐analysis

“…developed a prediction model containing PTA thresholds and presence of vertigo. Sensitivity ranged from 80% to 95% [95% CIs: unknown] and specificity from 74% to 38% [95% CIs: unknown] depending on the chosen cut‐off value …”

“…ABR was tested in five studies in a total of 652 patients . Hyperventilation test, electronystagmography, caloric irrigation, presenting symptoms and a prediction model were tested in one study each, comprising 102 100 102 881 and 420 patients, respectively …”

“…13,15,16,22,23 Hyperventilation test, electronystagmography, caloric irrigation, presenting symptoms and a prediction model were tested in one study each, comprising 102, 100, 102, 881 and 420 patients, respectively. 15,20,22,24 Quality assessment…”

Diagnostic Yield of a Routine Magnetic Resonance Imaging in Tinnitus and Clinical Relevance of the Anterior Inferior Cerebellar Artery Loops

“…Also, in a group of patients with a vestibular schwannoma without hearing loss, tinnitus was shown to be the presenting symptom in 14% of these patients (28). It has thus been recommended to screen patients with unilateral tinnitus without hearing loss for vestibular schwannoma (29), although the opposite has been recommended as well (30). In this study, we could not corroborate an indication for screening of these patients.…”

Potential savings in the diagnosis of vestibular schwannoma

“…[11][12][13][14][15][16][17][18][19][20][21][22] Our results show the merits of future research to focus on optimising these diagnostic algorithms. Furthermore, most diagnostic VS studies do not mention patients with pathology other than VS. 11,12,[14][15][16][17][18][19][20][21][22] In our diagnostic model, patients at risk of VS who turn out to have other relevant pathology were incorporated, because these pathologies are also being detected in the current diagnostic strategy. The incorporation of other pathology allowed us to not only evaluate the diagnostic cost of detecting VS patients, but also of patients with other pathology.…”