Comparison with other studies
A significant difficulty in establishing the sensitivity and specificity
of MRI for VS, is that the prevalence of VS is consistent across adult
populations, while the prevalence of ASNHL is highly variable. Efforts
have been made to establish auditory criteria for the selection of
patients who require further evaluation.
Pena10 reported that a criterion of 45 dB results in a
low specificity for detecting VS. In a retrospective chart review,
Saliba11Saliba I, Bergeron M, Martineau G, Chagnon M. Rule
3,000: a more reliable precursor to perceive vestibular schwannoma on
MRI in screened asymmetric sensorineural hearing loss. Eur Arch
Otorhinolaryngol. 2011 Feb;268(2):207-12. observed that 74 patients
with VS (diagnosed by MRI) had the greatest asymmetry at 3 kHz.
Our vestibular findings echo those observed by Blödow22Blödow A,
Helbig R, Wichmann N, Wenzel A, Walther LE, Bloching MB (2013) Video
head impulse test or caloric irrigation? Contemporary diagnostic tests
for vestibular schwannoma. HNO 61:781–785 who, using only horizontal
vHIT, reported a reduced gain of 0.76 ± 0.28 and sensitivity of 41.0%
in a group of 46 VS patients. Similarly, Taylor et al4reported a high prevalence of vestibular abnormality among VS patients.
They included patients with VS and symmetrical hearing (21.4% of the
study population), which could explain some differences with our study
regarding the prevalence of vestibular dysfunction.
Although several authors have studied VIN in patients with VS33Lee JM,
Kim MJ, Kim JW, Shim DB, Kim J, Kim SH.Vibration-induced nystagmus in
patients with vestibular schwannoma: Characteristics and clinical
implications. Clin Neurophysiol. 2017 Jul;128(7):1372-1379. , none
have investigated the potential role of the VIN test as a screening tool
for VS in an ASNHL population.
Lücke44Lücke
K. [A vibratory stimulus of 100 Hz for provoking pathological
nystagmus (author’s transl)].Z
Laryngol Rhinol Otol. 1973 Oct;52(10):716-20
Legends
Figure 1. Asymmetric NSHL patients were initially included. Patients
with previous otologic surgeries, acoustic trauma, and previous
vertigo symptoms were excluded of the study; NSHL: Neurosensorial
hearing loss
Figure 2. Bar graph representing sensitivity and specificity for every
vibration mastoid stimulation. The presence of the vibration induced
nystagmus represents the sensitivity. The absence of the vibration
induced nystagmus in the control group represents the specificity. A:
30 Hz ipsilateral mastoid vibration; B: 60 Hz ipsilateral mastoid
vibration; C:100 Hz ipsilateral mastoid vibration
Table 1. Mean VOR gain for horizontal, posterior and superior
semicircular canal in both Control and Vs groups. VS: vestibular
Schwannoma
Table 2. The ROC curves and the areas under the curves with
sensitivity and specificity results for each of its cut points. AUC:
Area under the curve; HSC: Horizontal canal; PSC: posterior
semicircular canal; SSC: superior semicircular canal was the first to
describe a correlation between vibratory stimulation and vestibular
lesions, concluding that VIN reflects peripheral vestibular imbalances.