Horizontal VOR function shows frequency dynamics in vestibular schwannoma

• Verfasst von: Blödow, Alexander [VerfasserIn]
• Verfasst von: Walther, Leif Erik [VerfasserIn]
• Titel: Horizontal VOR function shows frequency dynamics in vestibular schwannoma
• Verf.angabe: Alexander Blödow, Julia Blödow, Marc Boris Bloching, Ralf Helbig, Leif Erik Walther
• E-Jahr: 2015
• Jahr: 1 May 2014
• Jahr des Originals: 2014
• Umfang: 6 S.
• Fussnoten: Gesehen am 26.02.2018
• Titel Quelle: Enthalten in: European archives of oto-rhino-laryngology and head & neck
• Ort Quelle: Berlin : Springer, 1864
• Jahr Quelle: 2015
• Band/Heft Quelle: 272(2015), 9, Seite 2143-2148
• ISSN Quelle: 1434-4726
• DOI: doi:10.1007/s00405-014-3042-2
• Datenträger: Online-Ressource
• Sprache: eng
• K10plus-PPN: 1570194726

Abstract

The objective of this retrospective study was to investigate the horizontal vestibulo-ocular reflex (hVOR) pathway with caloric test (low-frequency hVOR) and video head impulse test (vHIT) (high-frequency hVOR) in patients with sporadic vestibular schwannoma (69 patients, 27-86 years, mean age 58.1 years) and to compare both test methods in terms of their sensitivity and specificity to detect a retrocochlear lesion. Test results with a unilateral weakness (UWCaloric) >25 % (caloric test) or a Mean-GainvHIT <0.79/asymmetry ratio of Gain (AR-GainvHIT) >8.5 % and accompanied refixation saccades (vHIT) were considered abnormal. The overall sensitivity of the caloric test was 72 %. The evaluation of AR-GainvHIT detected more abnormal cases than did Mean-GainvHIT (44 vs. 36 %). In up to 4 %, a normal caloric test result was related to an abnormal vHIT. There was only a moderate correlation of UWCaloric and AR-GainvHIT (r = 0.54, p < 0.05) with a linear regression line intercept/slope of 32.2/0.9 (p < 0.05). Receiver operating characteristics curve analysis exhibited at a UWCaloric of 50 % a vHIT sensitivity/specificity/positive predictive value/negative predictive value of 0.45/0.9/0.94/0.42. Vestibular testing at varying frequencies provides deeper insights into hVOR function and is helpful in detecting a cerebello-pontine lesion. Whereas caloric test yields a high sensitivity for nerve dysfunction, vHIT test reveals a remaining function of hVOR in the high-frequency range.