Vestibular Schwannoma and Ipsilateral Endolymphatic Hydrops: An Unusual
            Association

Ralli, Massimo; Greco, Antonio; Altissimi, G; Turchetta, Rosaria; Longo, Lucia; D’Aguanno, Vittorio; Tombolini, Mario; Cianfrone, Giancarlo; Vincentiis, Marco de

doi:10.5935/0946-5448.20170024

Cited by 8 publications

(6 citation statements)

References 25 publications

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“…Diagnosis should always include brain magnetic resonance imaging to exclude concurrent retrocochlear conditions i.e. vestibular schwannoma 69,70 and further characterize the neuroanatomical basis of the auditory deficit 19 .…”

Section: Clinical Management Of Patients With Alzheimer's Disease and Hearing Lossmentioning

confidence: 99%

Hearing loss and Alzheimer?s disease: A Review

Ralli¹,

Gilardi²,

Stadio³

et al. 2019

The International Tinnitus Journal

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Many studies have focused on the relationship between hearing loss and Alzheimer's Disease (AD). The mechanisms and causal relationship of this association are still partially unknown, and several theories have been proposed. The most accredited hypothesis is that peripheral hearing deprivation may lead to social isolation and subsequently to dementia. Another hypothesis supports the role of hearing loss on cortical processing, with an increased assignment of cognitive resources to auditory processing rather than to other cognitive processes; other theories suggest changes in the brain structure following reduced peripheral auditory stimulation, or a common cause to both conditions. These preliminary findings clearly delineate the importance of further research aimed at investigating hearing impairment in AD, to a) allow early detection of people with predisposition to AD, b) improve the quality of life in AD patients with hearing loss and c) possibly prevent the progression of the disease treating the hearing impairment. In this review paper, the authors discuss current evidence on the association between hearing impairment and dementia, the identification of peripheral and central auditory dysfunction in at-risk patients as a potential early indicator of incipient AD, and the clinical aspects and the management of patients with AD and hearing loss.

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Section: Clinical Management Of Patients With Alzheimer's Disease and Hearing Lossmentioning

confidence: 99%

Hearing loss and Alzheimer?s disease: A Review

Ralli¹,

Gilardi²,

Stadio³

et al. 2019

The International Tinnitus Journal

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“…It has also been suggested that some patients with VS also suffer from dysfunctions of the secretion and resorption of endolymphatic liquid, potentially with associated hydrops ( 34 ) due to the inflammatory process occurring around the vestibular schwannoma ( 35 ). None of our subjects displayed an abnormal vHIT result with a normal caloric test result.…”

Section: Discussionmentioning

confidence: 99%

A New Sensitive Test Using Virtual Reality and Foam to Probe Postural Control in Vestibular Patients: The Unilateral Schwannoma Model

et al. 2022

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Vestibular schwannomas (VS) are benign tumors of the vestibular nerve that may trigger hearing loss, tinnitus, rotatory vertigo, and dizziness in patients. Vestibular and auditory tests can determine the precise degree of impairment of the auditory nerve, and superior and inferior vestibular nerves. However, balance is often poorly quantified in patients with untreated vestibular schwannoma, for whom validated standardized assessments of balance are often lacking. Balance can be quantified with the EquiTest. However, this device was developed a long time ago and is expensive, specific, and not sensitive enough to detect early deficits because it assesses balance principally in the sagittal plane on a firm platform. In this study, we assessed postural performances in a well-defined group of VS patients. We used the Dizziness Handicap Inventory (DHI) and a customized device consisting of a smartphone, a mask delivering a fixed or moving visual scene, and foam rubber. Patients were tested in four successive sessions of 25 s each: eyes open (EO), eyes closed (EC), fixed visual scene (VR0), and visual moving scenes (VR1) delivered by the HTC VIVE mask. Postural oscillations were quantified with sensors from an android smartphone (Galaxy S9) fixed to the back. The results obtained were compared to those obtained with the EquiTest. Vestibulo-ocular deficits were also quantified with the caloric test and vHIT. The function of the utricle and saccule were assessed with ocular and cervical vestibular-evoked myogenic potentials (o-VEMPs and c-VEMPs), respectively. We found that falls and abnormal postural oscillations were frequently detected in the VS patients with the VR/Foam device. We detected no correlation between falls or abnormal postural movements and horizontal canal deficit or age. In conclusion, this new method provides a simpler, quicker, and cheaper method for quantifying balance. It will be very helpful for (1) determining balance deficits in VS patients; (2) optimizing the optimal therapy indications (active follow-up, surgery, or gamma therapy) and follow-up of VS patients before and after treatment; (3) developing new rehabilitation methods based on balance training in extreme conditions with disturbed visual and proprioceptive inputs.

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“…Although many hypotheses have been presented in the present literature to explain the mechanisms underlying the SNHL induced by VSs, its pathogenesis is likely multifactorial and remains debated. Among the possible explanations proposed include mechanical compression by VSs on the auditory nerve or the labyrinthine artery (Lassaletta et al 2019), ototoxic and neurotoxic VS-biological secretions (Dilwali et al 2015; Lassaletta et al 2019) as well as the presence of ELH (Roosli et al 2012; Hizli et al 2016; Eliezer et al 2019; Karch-Georges et al 2019), which has been described by radiological studies and histological reports of temporal bones, but has been rarely reported in the clinical practice, mostly in case reports (Ralli et al 2017).…”

Section: Discussionmentioning

confidence: 99%

Intraoperative Electrocochleography in Subjects Affected by Vestibular Schwannoma and Ménière’s Disease: Comparison of Results

et al. 2021

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Histologic reports of temporal bones of ears with vestibular schwannomas (VSs) have indicated findings of endolymphatic hydrops (ELH) in some cases. The main goal of this investigation was to test ears with VSs to determine if they exhibit electrophysiological characteristics similar to those of ears expected to experience ELH.Design: Fifty-three subjects with surgically confirmed VS aged ≥18 and with normal middle ear status were included in this study. In addition, a second group of adult subjects (n = 24) undergoing labyrinthectomy (n = 6) or endolymphatic sac decompression and shunt (ELS) placement (n = 18) for poorly controlled vestibular symptoms associated with Meniere's disease (MD) participated in this research. Intraoperative electrocochleography (ECochG) from the round window was performed using tone burst stimuli. Audiometric testing and word recognition scores (WRS) were performed preoperatively. ECochG amplitudes, cochlear microphonic/auditory nerve neurophonic (ANN) in the form of the "ongoing" response and summation potential, were analyzed and compared between the two groups of subjects. In addition, to evaluate any effect of auditory nerve function, the auditory nerve score was calculated for each subject. Pure-tone averages were obtained using the average air conduction thresholds at 0.5, 1, and 2 kHz while WRS was assessed using Northwestern University Auditory Test No. 6 word lists. Results:In the VS group the average pure-tone averages and WRS were 59.6 dB HL and 44.8%, respectively, while in the MD group they were 52.3 dB HL and 73.8%. ECochG findings in both groups revealed a reduced trend in amplitude of the ongoing response with increased stimulus frequency. The summation potential amplitudes of subjects with VS were found to be less negative than the MD subjects for nearly all test frequencies. Finally, the VS group exhibited poorer amounts of auditory nerve function compared to the MD group. Conclusions:The current findings suggest cochlear pathology (e.g., hair cell loss) in both groups but do not support the hypothesis that VSs cause ELH.

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Vestibular Schwannoma and Ipsilateral Endolymphatic Hydrops: An Unusual Association

Cited by 8 publications

References 25 publications

Hearing loss and Alzheimer?s disease: A Review

Hearing loss and Alzheimer?s disease: A Review

A New Sensitive Test Using Virtual Reality and Foam to Probe Postural Control in Vestibular Patients: The Unilateral Schwannoma Model

Intraoperative Electrocochleography in Subjects Affected by Vestibular Schwannoma and Ménière’s Disease: Comparison of Results

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