Evaluation of Vestibular Function in Diagnosis of Vestibular Schwannomas

Vestibular schwannomas(VS)are benign tumors of the vestibular nerve.The common first symptoms are hearing loss and tinnitus,followed by imbalance,vertigo,and facial nerve involvement.The subjective symptoms of VS patients are not consistent with the severity of vestibular lesions and the results of vestibular tests,which often interfere with clinicians’diagnoses.Thus,the main screening and diagnostic methods for VS are audiometry and magnetic resonance imaging(MRI),ignoring the evaluation of vestibular function at the source of pathological lesions.With the development and improvement of vestibular evaluation technology and its wide application in the clinic,modern vestibular examination technology can reflect the severity and frequency of vestibular lesions and compensation from multiple perspectives,providing an objective basis for the diagnosis and treatment of vestibular diseases.In this report,we review the results and characteristics of vestibular tests in VS patients and further clarify the clinical value of vestibular function assessment in the diagnosis and treatment of VS.

Vestibular function of pediatric patients with sudden sensorineural hearing loss:based on vertigo symptom and vestibular function testing

Background This study aimed to evaluate the relationship between vestibular and auditory functions in pediatric patients with sudden sensorineural hearing loss(SSHL).Methods A total of 30 pediatric patients experiencing unilateral SSHL between 5.9 and 13.0 years of age were enrolled in this study.Pure tone audiometry was evaluated prior to treatment initiation and again after one month of treatment.Prior to treatment initiation,vertigo symptoms were noted;then several vestibular function tests were conducted including caloric testing,ocular vestibular evoked myogenic potentials(o-VEMPs)and cervical vestibular evoked myogenic potentials(c-VEMPs).Associations between pre and post-treatment vestibular function and hearing threshold levels were analyzed.Results Initial hearing thresholds of children with vertigo were higher than thresholds of children without vertigo(92 dB vs 79 dB,F=0.033),while initial hearing thresholds of children with abnormal caloric test findings were higher than thresholds of children with normal caloric test findings(93 dB vs 67 dB.P=0.014).Cutoff values of hearing thresholds for those with vertigo symptoms and abnormal vestibular test results were 86.000-and 89.583-dB HL.respectively.Regarding prognosis,children with vertigo exhibited lower recovery rates than children without vertigo(33%vs 75%,P=0.025);recovery rates of children with abnormal caloric test results were lower than the overall recovery rate(25%vs 73%,respectively,P=0.039).Conclusion Assessments of vertigo symptoms and vestibular function are useful tools in predicting pediatric SwSHL patient disease severity and prognosis.

Implementation of a Subjective Visual Vertical and Horizontal Testing System Using Virtual Reality

Subjective visual vertical(SVV)and subjective visual horizontal(SVH)tests can be used to evaluate the perception of verticality and horizontality,respectively,and can aid the diagnosis of otolith dysfunction in clinical practice.In this study,SVV and SVH screen version tests are implemented using virtual reality(VR)equipment;the proposed test method promotes a more immersive feeling for the subject while using a simple equipment configuration and possessing excellent mobility.To verify the performance of the proposed VR-based SVV and SVH tests,a reliable comparison was made between the traditional screen-based SVV and SVH tests and the proposed method,based on 30 healthy subjects.The average results of our experimental tests on the VR-based binocular SVV and SVH equipment were−0.15◦±1.74 and 0.60◦±1.18,respectively.The proposed VR-based method satisfies the normal tolerance for horizontal or vertical lines,i.e.,a±3◦error,as defined in previous studies,and it can be used to replace existing test methods.