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Quantitative analysis of vestibular response in cerebello-pontine angle tumors
Abstract:
The results obtained by vestibular examination are reported for 20 patients with cerebellopontine angle tumours. Eye pursuits, spontaneous, positional and caloric induced nystagmus (lateral and directional preponderance for duration, frequency and speed of slow phase) were evaluated in order to identify the most sensitive parameter. Half cases showed abnormalities in eye tracking test, one third a spontaneous nystagmus, 5% only a positional nystagmus. A lateral preponderance of the healthy side was found in 95% of the cases when calculated on the slow phase velocity of the caloric nystagmus, while lower rates were obtained with duration (79%) and frequency (74%). These results suggest that an asymmetry in the speed of slow phase of the caloric nystagmus is the most relevant sign to proceed to X-ray examination, especially if found in cases where the residual hearing does not allow reliable audiometric results.
Insights
Vestibular examination of cerebellopontine angle tumors revealed that slow phase velocity asymmetry in caloric nystagmus is the most sensitive indicator. This finding aids in identifying tumors, especially when hearing loss impacts audiometric results.
Area of Science:
- Neurology
- Otolaryngology
- Neurosurgery
Background:
- Cerebellopontine angle (CPA) tumors can affect vestibular function.
- Early detection of CPA tumors is crucial for effective treatment and patient outcomes.
Purpose of the Study:
- To evaluate vestibular examination parameters for identifying the most sensitive indicator of CPA tumors.
- To determine the utility of vestibular testing in cases with compromised hearing.
Main Methods:
- Vestibular examinations were performed on 20 patients with CPA tumors.
- Evaluated parameters included eye pursuits, spontaneous, positional, and caloric-induced nystagmus (analyzing lateral and directional preponderance for duration, frequency, and slow phase velocity).
Main Results:
- Abnormalities in eye tracking were observed in 50% of cases, spontaneous nystagmus in 33%, and positional nystagmus in 5%.
- Lateral preponderance on the healthy side, calculated on slow phase velocity of caloric nystagmus, was found in 95% of cases.
- Lower detection rates were observed using duration (79%) and frequency (74%) of caloric nystagmus.
Conclusions:
- Asymmetry in the slow phase velocity of caloric nystagmus is the most significant vestibular sign for detecting CPA tumors.
- This parameter is particularly valuable when audiometric results are unreliable due to hearing loss.