J Audiol Otol.  2022 Jan;26(1):36-42. 10.7874/jao.2021.00374.

Diagnostic Validity of Auditory Brainstem Response for the Initial Screening of Vestibular Schwannoma

• Park MJ
• Ahn JH
• Park HJ
• Chung JW
• Kang WS

• KMID: 2524220
• DOI: http://doi.org/10.7874/jao.2021.00374

Abstract

Background and Objectives
To investigate the diagnostic validity of auditory brainstem response (ABR) in the screening of vestibular schwannoma (VS).
Subjects and Methods
Forty patients diagnosed with VS using magnetic resonance imaging who had undergone ABR before treatment between 2005 and 2015 were included. ABR results were considered positive when findings met at least one of the following criteria: 1) absent evoked response, 2) desynchronization of waves other than wave I, 3) interpeak latency (IPL) between waves I and III >2.5 ms, 4) IPL between waves I and V >4.4 ms, 5) wave V interaural latency difference >0.2 ms, and 6) interaural difference in IPL between waves I and V >0.2 ms.
Results
The overall sensitivity of ABR was 85.0%. For tumors measuring <10 mm, the sensitivity of ABR was 66.7%, whereas it increased to 90.3% for tumors measuring >10 mm. The sensitivity of tumors confined to the internal acoustic canal was 73.3% compared with 100.0% for tumors confined to the cerebellopontine angle. In patients with serviceable hearing, the mean tumor size was 7.8±2.9 mm in patients with a normal ABR and 15.1±9.4 mm in patients with an abnormal ABR, indicating a significant difference (p<0.05).
Conclusions
ABR alone is insufficient for the screening of VS, bearing the risk of false-negative outcomes when examining small, intracanalicular tumors. However, ABR can be inexpensively applied for the screening of VS measuring >10 mm in patients with serviceable hearing, supporting the need for further active diagnostic and treatment modalities in clinical practice.

Keyword

Vestibular schwannoma; Auditory brainstem response; Magnetic resonance image