(442) Sensitivity of Vestibular Tests in 137 Vestibular Schwannoma Patients

Monday, October 2, 2023

2:45 PM – 3:45 PM East Coast USA Time

Presenting Author(s)

Kathrin Skorpa Nilsen, MD

Otolaryngologist
Haukeland University Hospital
Rådal, Hordaland, Norway

Senior Author(s)

FG

Frederik Kragerud Goplen, MD PhD

Consultant. PhD
Haukeland University Hospital
Bergen, Hordaland, Norway

Co-Author(s)

Stein Helge Glad Nordahl, MD PhD

Professor. Senior Consultant. PhD
Haukeland University Hospital & University of Bergen
Bergen, Hordaland, Norway
Berge Jan Erik, MD PhD

Neurotologist
Department of Otolaryngology Head and Neck Surgery, Haukeland University Hospital
Bergen, Hordaland, Norway
DD

Dhanushan Dhayalan, MD

Haukeland University Hospital, USA

Disclosure(s):

Kathrin Skorpa Nilsen, MD: No relevant relationships to disclose.

Stein Helge Glad Nordahl, MD PhD: No relevant relationships to disclose.

Berge Jan Erik, MD PhD: No relevant relationships to disclose.

Introduction: The video head impulse test (vHIT) and the cervical and ocular vestibular evoked myogenic potentials (cVEMP and oVEMP) are new methods for measuring peripheral vestibular function. The aims of this study were to compare these tests and the traditionally used caloric test in patients with untreated vestibular schwannoma (VS) and to measure correlation between the tests’ results and tumor volume.

Methods: This is a national cross-sectional study of 137 consecutive patients referred to a university clinic for newly diagnosed untreated small to medium-sized VS enrolled in the period 2017-2019. Prevalence of abnormal test results in the tumor side and the non-tumor side of cVEMP, oVEMP, caloric test and 6-canal vHIT were compared and related to tumor volume with regression analysis.

Results: The sensitivity to detect vestibulopathy in a VS patient were for 6-canal vHIT 51%, caloric test 47%, cVEMP 39% and oVEMP 25%. Normal tests were found in 21% of the patients. The results of vHIT and caloric test were related to tumor volume (P≤0.03 for all semicircular canals, P= 0.001, respectively).

Conclusions: Caloric test and the 6-canal vHIT showed the highest sensitivity in detecting vestibulopathy in untreated VS patients. vHIT, and particularly the posterior canal, was limited with a high prevalence of abnormal results on the non-tumor side. A combination of cVEMP and caloric test was favorable in terms of a relatively high sensitivity and a low prevalence of abnormal results in the non-tumor side.