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KMID : 0361020230660100655
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Korean Journal of Otolaryngology - Head and Neck Surgery
2023 Volume.66 No. 10 p.655 ~ p.662
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Nystagmus Based Screening System for Vestibular Schwannoma in Patients With Asymmetric Hearing Loss
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Hong Joon-Pyo
Lee Jung-Yup
Kim Min-Beom
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Abstract
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Background and Objectives We conducted this study to propose a nystagmus based screen-ing system (NBSS) for detecting vestibular schwannoma (VS) in patients with asymmetric sen-sorineural hearing loss (ASNHL).
Subjects and Method Data of 90 patients diagnosed with VS were retrospectively analysed.
For the 1:1 allocation, 90 ASNHL patients who were not diagnosed with VS were sequentiallyenrolled as the non-VS group and retrospectively analysed. Every participant received puretone audiometry (PTA), a bedside vestibular function test, and magnetic resonance imaging.
A total of 122 patients who passed the exclusion criteria were selected for the study.
Results The sensitivity and specificity of the abnormal criteria of auditory brainstem re-sponse (ABR) for the detection of VS in patients (n=70) showing analyzable wave responsewere 80.0% and 52.0%, respectively. However, when we included all of the patients (n=122)who did not show analyzable wave response in ABR, the sensitivity and specificity of the ab-normal criteria decreased to 34.8% and 68.4%, respectively. NBSS is composed of verticalspontaneous nystagmus, direction changing gaze evoked nystagmus, ipsilesional monophasictype head shaking nystagmus (HSN), and ipsilesional to contralesional biphasic type HSN.
The sensitivity and specificity of the NBSS were 56.5% and 82.9%, respectively.
Conclusion NBSS may be used as a supplementary test to ABR in detecting VS of ASNHL.
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KEYWORD
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Auditory brainstem response, Hearing loss, Nystagmus, Vestibular schwannoma
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