Assessing vestibular function in patients with vestibular schwannoma: a comprehensive multi-test vestibular evaluation

Purpose: We present the results of a battery of vestibular tests on a cohort of Vestibular Schwannoma (VS) patients. We aim to describe the efficacy and sensitivity of those tests in assessing vestibular function and identifying impairment caused by VS. Methods: A retrospective study was conducted in a tertiary referral centre, the University Hospital of Padova and the Regional Specialised Centre of Veneto Region for Diagnosis and Cure of Vertigo (Sant’Antonio University Hospital). We enrolled and evaluated 50 patients referred for surgical treatment and newly diagnosed with undergoing observational management. The patients underwent a vestibular multi-tests in-home protocol, including videonystagmography (VNG), caloric tests (CalT), video head impulse test (vHIT), cervical and ocular vestibular evoked myogenic potentials (cVEMPs and oVEMPs) and posturography. We analysed the alteration rate of vestibular tests in detecting vestibular impairment caused by VS. Results: Vestibular tests showed high levels of sensitivity, which increased in the case of simultaneous use (VNG and CalT with vHIT: 100%). The results of vHIT tests also correlated with tumour characteristics such as size and location (p < 0.05). Conclusions: We comment on the usefulness of a multi-test vestibular evaluation of VS patients. Integrating these tests improves the sensitivity of detection of vestibular impairment.