Video Head Impulse Test to Preoperatively Identify the Nerve of Origin of Vestibular Schwannomas

Constanzo, Felipe; Sens, Patrícia Maria; Teixeira, Bernardo Corrêa de Almeida; Ramina, Ricardo

doi:10.1093/ons/opy103

Cited by 12 publications

(16 citation statements)

References 31 publications

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“…Based on these findings, we believe that the nerve origin of VS can be predicted using vestibular function tests, including the caloric, vHIT, and VEMP tests. Since the origin of the tumor is an important prognostic factor, several attempts have been made to predict it with various vestibular function tests, hearing status, and by using MRI [ 6 , 12 , 13 , 15 , 16 , 24 ]. Due to the close relationship between the tumor and cochlear nerve under the transverse crest within the internal auditory canal, removal of VS originating from the IVN is considered to be responsible for the low rate of hearing preservation, but it is also associated with an increased chance of intraoperative trauma to the cochlear nerve [ 5 , 9 ].…”

Section: Discussionmentioning

confidence: 99%

“…However, most studies to preoperatively predict the origin using functional vestibular tests have been unsuccessful; even when they were successful, they were limited to relatively small tumors. As such, intraoperative identification remains the only reliable method [ 15 , 16 ].…”

Section: Discussionmentioning

confidence: 99%

“…The video head impulse test (vHIT), a relatively new vestibular-ocular response (VOR) test method, can quantitatively measure the VOR gain, as well as identify saccades on the horizontal canals (HCs), anterior canals (ACs), and posterior canals (PCs) [ 14 ]. However, there is limited information regarding the function of the three semicircular canals using vHIT, which may determine the origin of VS [ 15 , 16 , 17 ].…”

Section: Introductionmentioning

confidence: 99%

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Feasibility of Preoperative Video Head Impulse Test to Predict the Nerve of Origin in Patients with Vestibular Schwannomas

Nam

Bae

Kim

et al. 2021

JCM

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Vestibular schwannoma (VS) originates from Schwann cells in the superior or inferior vestibular nerve. Identifying the precise origin will help in determining the optimal surgical approach. We retrospectively analyzed the preoperative vestibular function test according to VS origin to determine whether the test is a valuable indicator of tumor origin. Forty-seven patients with VS (male:female = 18:29, mean age: 54.06 ± 13.50 years) underwent the cochleovestibular function test (pure-tone audiometry, caloric test, video head impulse test (vHIT), cervical and ocular vestibular-evoked myogenic potential, and posturography). All patients then underwent surgical removal of VS, and the schwannoma origin was confirmed. The tumor originated from the superior vestibular nerve (SVN group) in 21 patients, the inferior vestibular nerve (IVN group) in 26 patients, and an undetermined site in eight patients. The only value that differed significantly among the groups was the gain of the vestibular-ocular reflex (VOR) in the ipsilesional posterior canal (iPC) during the vHIT. Our results indicate that VOR gain in the iPC may be used to predict the nerve origin in patients with VS. Other cochleovestibular function tests have limited value to discriminate nerve origins, especially in cases of medium to large VS.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Feasibility of Preoperative Video Head Impulse Test to Predict the Nerve of Origin in Patients with Vestibular Schwannomas

Nam

Bae

Kim

et al. 2021

JCM

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“…Video head impulse testing (vHIT) was performed by an experienced neuro-otologist using ICS Impulse video goggles and Vestlab 7.1 software (Otometrics) for data analysis, according to a previously described protocol. 16 Briefly, the test consists of a system that senses head movement and recognises eye movement to quantify the vestibulo-ocular reflex (VOR). The examiner rotates the patient’s head several times on various planes to evaluate the lateral semi-circular, superior semi-circular and posterior semi-circular canals on both sides.…”

Section: Methodsmentioning

confidence: 99%

Brainstem hyperintensity in patients with vestibular schwannoma is associated with labyrinth signal on magnetic resonance imaging but not vestibulocochlear tests

et al. 2020

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Objectives Focal hyperintensity in the dorsal brainstem (HDB) has been described in large cerebellopontine angle tumours and is thought to represent vestibular nuclei degeneration, but its functional significance has not been thoroughly investigated. Our aim was to analyse its relationship to imaging characteristics of the tumour and inner-ear structures and to vestibulocochlear functional tests. Methods We retrospectively reviewed 54 patients with a histological diagnosis of vestibular schwannoma (VS). Magnetic resonance imaging tumour characteristics (size, cystic composition and distance from the cochlear aperture), signal intensity ratio of the cochlea and vestibule in fluid-attenuated inversion recovery (FLAIR) and fast imaging employing steady-state acquisition (FIESTA)/fast spin-echo imaging with variable flip angles (CUBE) and vestibulocochlear function tests (audiometry, auditory brainstem response (ABR) and video head impulse testing (vHIT)) were obtained. Statistical analyses were performed to evaluate their relation to focal HDB. Results Focal HDB was found in 22% of VS. It was significantly associated with large ( p < 0.001) and cystic ( p = 0.004) tumours and also with tumours located further from the cochlear aperture ( p = 0.039). The signal intensity ratio of the cochlea on FLAIR was higher in patients with HDB ( p < 0.014), but this difference was not observed in FIESTA/CUBE ( p = 0.981). Audiometry, ABR and vHIT results did not significantly differ in patients with HDB, but ABR results were worse in patients with higher cochlear signal intensity on FLAIR sequences ( p = 0.026). Conclusions Focal HDB in patients with VS was associated with increased signal intensity ratio of the cochlea on FLAIR in patients with VS but not directly to the results of vestibulocochlear function tests.

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“…A retrospective study found, that inferior vestibular nerve tumors were twice as common as superior nerve tumors [27]. Additionally, the nerve of origin in VS is an important prognostic factor for hearing preservation surgery [28]. Moreover, vertical SCC testing helps evaluating superior canal function in patients with superior canal dehiscence syndrome [29].…”

Section: Limitations Of the Studymentioning

confidence: 99%

Normative Vestibular-Ocular Reflex Gain Values for the Vertical Semicircular Canals

2020

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Objectives: To determine normative vestibular-ocular-reflex (VOR) gain values for the vertical semicircular canals (SCCs) within a Danish cohort of healthy adults. Normative data regarding the vertical SCCs are sparse. Assessing the function of all 6 SCCs is important, as some vestibular diseases may selectively affect specific SCCs. Methods: A prospective cross-sectional study of 60 subjects aged 18-65 years with no previous vestibular disorders. All subjects underwent complete examination of all 6 SCCs with EyeSeeCam video head impulse test (vHIT) system. Results: Mean VOR gain values of the right anterior and left posterior canal were 1.46 and 1.43 respectively. For the left anterior and right posterior canals, mean VOR gain values were 0.96 and 0.97 respectively. Conclusions: Our results suggest that mean VOR gain is close to 1.4 in the right anterior and left posterior plane and close to one for the left anterior and right posterior plane when testing the vertical SCCs in healthy adults with the EyeSeeCam vHIT system.

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Video Head Impulse Test to Preoperatively Identify the Nerve of Origin of Vestibular Schwannomas

Abstract: The pattern of semicircular canal dysfunction on vHIT has a localizing value to identify the nerve of origin in VSs.

Cited by 12 publications

References 31 publications

Feasibility of Preoperative Video Head Impulse Test to Predict the Nerve of Origin in Patients with Vestibular Schwannomas

Feasibility of Preoperative Video Head Impulse Test to Predict the Nerve of Origin in Patients with Vestibular Schwannomas

Brainstem hyperintensity in patients with vestibular schwannoma is associated with labyrinth signal on magnetic resonance imaging but not vestibulocochlear tests

Normative Vestibular-Ocular Reflex Gain Values for the Vertical Semicircular Canals

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