Hearing and balance in vestibular schwannoma – a 12-year clinical perspective

Abstract

Introduction/Objective Vestibular schwannoma (VS) is a benign tumor originating from Schwann cells, predominantly affecting the vestibular portion of the eighth cranial nerve. It is the most common tumor of the cerebellopontine angle, presenting with varying degrees of hearing loss, along with tinnitus and vestibular symptoms. This paper gives a comprehensive analysis of the degree of hearing and balance impairment in individuals presenting with VS, along with a detailed clinical perspective.

Methods The research involved a retrospective analysis of the clinical database utilizing available medical records from the Audiology Department of a major tertiary care hospital in Serbia. It encompassed 83 patients diagnosed with VS between 2011 and 2023, with presenting symptoms of hearing and/or balance impairment. The analysis included basic demographic data, presenting symptoms, and results of tonal liminal audiometry, alongside specific vestibular diagnostic tests and imaging.

Results A significant hearing loss was observed in the majority of patients with VS (p < 0.01), with 48.7% having a severe degree of sensorineural hearing loss. Increasing age was positively associated with higher degrees of hearing impairment, as expected (p < 0.05). Dizziness was present in 15.6% of patients, while postural instability was reported by 29% of patients. The impairment of the vestibulo-ocular reflex of the lateral semicircular canal was observed in 62.7% of cases.

Conclusion The study provides insight into the hearing and balance of patients with VS. The results highlight the need for continuous monitoring, both pre- and postoperatively, to understand the relationships between patients’ characteristics, symptoms, degree of hearing impairment, and tumor localization. These data are crucial for improving diagnostic and multidisciplinary therapeutic approaches to enhance the quality of care and function in these patients.

Keywords: vestibular schwannoma; hearing loss; dizziness; cerebellopontine angle