Comparison of vestibular function between large cerebellopontine angle meningioma and schwannoma

Abnormal caloric and vestibular evoked myogenic potential (VEMP) responses are frequently encountered with a large cerebellopontine angle (CPA) schwannoma, while normal caloric responses and abnormal VEMPs are noted with a large CPA meningioma. This difference may possibly exist because schwannoma causes vestibular deficits via parenchymal involvement, while vestibular deficits in the meningioma are mostly due to compression neuropathy.

This study aimed to compare the tumor characteristics in relation to vestibular function, i.e. caloric and VEMP responses, between large-sized (>2.5 cm) meningioma and schwannoma in the CPA.

Five patients with large CPA meningioma and nine patients with large CPA schwannoma were enrolled in this study. Each patient underwent a battery of tests including audiometry, caloric test, VEMP test, and MRI study.

The meningioma group showed 20% caloric abnormality and 75% VEMP abnormality, while the schwannoma group revealed 100% caloric and 100% VEMP abnormalities. A significant difference existed in relation to caloric abnormality between the two groups, but not in relation to VEMP abnormality.