Significance of Vestibular Testing on Distinguishing the Nerve of Origin for Vestibular Schwannoma and Predicting the Preservation of Hearing

He, Yubo; Yu, Chunmei; Ji, Hongming; Qu, Yanming; Chen, Ning

doi:10.4103/0366-6999.178958

Cited by 21 publications

(14 citation statements)

References 15 publications

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“…He et al, using cVEMPs and caloric test abnormalities, found the nerve source of the tumor could be predicted in only 22 of 68 patients, as the majority had abnormalities on both tests. 97 Similarly, both Suzuki et al and Ushio et al found similar rates of cVEMP abnormalities for schwannoma originating from either nerve division. 98,99 Despite most schwannoma originating from the vestibular nerve, secondary changes in the labyrinth are known to occur.…”

Section: Vestibular Neuritismentioning

confidence: 76%

“…This would be an advantage clinically since hearing preservation is often better for schwannoma arising from the superior nerve. 96,97 Unfortunately, studies do not support this. He et al, using cVEMPs and caloric test abnormalities, found the nerve source of the tumor could be predicted in only 22 of 68 patients, as the majority had abnormalities on both tests.…”

Section: Vestibular Neuritismentioning

confidence: 99%

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Vestibular-Evoked Myogenic Potential Testing in Vestibular Localization and Diagnosis

et al. 2020

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Vestibular-evoked myogenic potentials (VEMPs) are short-latency, otolith-dependent reflexes recorded from the neck and eye muscles. They are widely used in neuro-otology clinics as tests of otolith function. Cervical VEMPs are recorded from the neck muscles and reflect predominantly saccular function, while ocular VEMPs are reflexes of the extraocular muscles and reflect utricular function. They have an important role in the diagnosis of superior canal dehiscence syndrome and provide complementary information about otolith function that is useful in the diagnosis of other vestibular disorders. Like other evoked potentials, they can provide important localizing information about lesions that may occur along the VEMP pathway. This review will describe the VEMP abnormalities seen in common disorders of the vestibular system and its pathways.

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Section: Vestibular Neuritismentioning

confidence: 76%

Section: Vestibular Neuritismentioning

confidence: 99%

Vestibular-Evoked Myogenic Potential Testing in Vestibular Localization and Diagnosis

et al. 2020

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“…Previous studies established a possibility for prediction of the prognosis of hearing preservation surgery in VSs [18][19][20] . Also, there are studies on intraoperative findings of tumor origin, SVN(superior vestibular nerve), and IVN (inferior vestibular nerve), and concludes SVN originating tumors is associated with better hearing preservation 19,20,24 . Preoperative determination of tumor origin (SVN or IVN) has some controversies; a study by Ushio et al demonstrates no significant correlation of localizing tumor origin 25 .…”

Section: Discussionmentioning

confidence: 99%

“…Preoperative determination of tumor origin (SVN or IVN) has some controversies; a study by Ushio et al demonstrates no significant correlation of localizing tumor origin 25 . On the other hand, other papers show the usefulness of caloric and vestibular-evoked myogenic potential(VEMP) for determining tumor origin 24,26 .…”

Section: Discussionmentioning

confidence: 99%

“…Electronic medical records of 50 pathologically confirmed vestibular schwannoma patients via MCFA or RSA for excision were obtained. After reviewing previous literature for possible predictors of postoperative hearing 8,[18][19][20]24,27 , the following preoperative measures were put into the learning model: 1) Pure-tone threshold of each frequency, 2) maximal word recognition score(WRS), speech detection threshold(SDT), most comfortable level of hearing(MCL), 3) Auditory brainstem response(ABR) latency of wave I-V interval, 4) asymmetry ratio of vestibular-evoked myogenic potential (VEMP), 5) canal paresis(CP) in caloric test of affected site, 6) maximum diameter of the tumor, and 7) type of approach (RSA or MCFA). Since the model was aimed to predict postoperative hearing preservation with preoperative tests, all intraoperative factors were not taken into account.…”

Section: Data Acquisition Selection and Patient Classificationmentioning

confidence: 99%

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Machine learning approach for prediction of hearing preservation in vestibular schwannoma surgery

Cha

Shin

Kim

et al. 2020

Sci Rep

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in vestibular schwannoma patients with functional hearing status, surgical resection while preserving the hearing is feasible. Hearing levels, tumor size, and location of the tumor have been known to be candidates of predictors. We used a machine learning approach to predict hearing outcomes in vestibular schwannoma patients who underwent hearing preservation surgery: middle cranial fossa, or retrosigmoid approach. After reviewing the medical records of 52 patients with a pathologically confirmed vestibular schwannoma, we included 50 patient's records in the study. Hearing preservation was regarded as positive if the postoperative hearing was within serviceable hearing (50/50 rule). The categorical variable included the surgical approach, and the continuous variable covered audiometric and vestibular function tests, and the largest diameter of the tumor. Four different algorithms were lined up for comparison of accuracy: support vector machine(SVM), gradient boosting machine(GBM), deep neural network(DNN), and diffuse random forest(DRF). The average accuracy of predicting hearing preservation ranged from 62% (SVM) to 90% (DNN). The current study is the first to incorporate machine learning methodology into a prediction of successful hearing preservation surgery. Although a larger population may be needed for better generalization, this study could aid the surgeon's decision to perform a hearing preservation approach for vestibular schwannoma surgery.Vestibular schwannomas (VSs), or acoustic neuromas are benign tumors arising from the cochleovestibular nerve, which grows slowly 1 . It accounts for 6-8% of all intracranial tumors and is the most common cerebellopontine angle tumor 2 . Recently, with the help of better access to magnetic resonance imaging, the incidence has been increased, and the tumor size at the time of diagnosis has decreased 3,4 . With more early detection rates, more patients are asymptomatic when diagnosed. In these patients, the following management options may all be feasible: watchful waiting, surgery, or stereotactic radiosurgery(SRS). However, there are no clear guidelines or consensus on the optimal management of small VSs, and the optimal treatment is still under debate 5,6 . Treatment options differ individually and are dependent upon the physician's experience, the size and growth rate of the tumor, age, patient's preference, and hearing status. If the tumor is too big, or hearing is below serviceable hearing, hearing preservation is not essential in treatment 7 . Nevertheless, in small to medium-sized tumors with serviceable hearing, hearing preservation surgeries can be offered. Currently, middle cranial fossa approach(MCFA) and retrosigmoid approach(RSA) are the two most commonly used approaches to remove VSs.The selection between the two approaches depends on the size and location of the tumor, and the surgeon's preference, as each procedure has its strengths in exposing regions of the internal auditory canal or cerebellopontine angle. The preservation rate of MCFA and RSA varies...

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Vestibular Testing to Predict the Nerve of Origin of Vestibular Schwannomas

Campione

Cacciotti

Roperto

et al. 2019

Advances in Vestibular Schwannoma Microneurosurgery

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Significance of Vestibular Testing on Distinguishing the Nerve of Origin for Vestibular Schwannoma and Predicting the Preservation of Hearing

Cited by 21 publications

References 15 publications

Vestibular-Evoked Myogenic Potential Testing in Vestibular Localization and Diagnosis

Vestibular-Evoked Myogenic Potential Testing in Vestibular Localization and Diagnosis

Machine learning approach for prediction of hearing preservation in vestibular schwannoma surgery

Vestibular Testing to Predict the Nerve of Origin of Vestibular Schwannomas

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