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Background: A vestibular schwannoma (VS) is a benign tumor that arises from the Schwann cells. Prompt diagnosis and the use of intraoperative monitoring of hearing (IM) during the removal of the tumor increases the probability ofhearing preservation. During the operation, various IM can be used: auditory brainstem responses (ABR), transtympanal electrocochleography (TT-ECochG) and distortion product otoacoustic emissions (DPOAE). Objective: The aim of this study was to determine the usefulness of IM during the VS removal operation and to analyze the changes in morphology of auditory potentials records in relation to hearing after the operation. Material and Methods: Retrospective analysis was done of the audiological tests results and the records of IM performed with 15 patients with vestibular schwannoma. Analyzed were: threshold of hearing, speech intelligibility, ABR wave V latency, action potential (AP) amplitude and latency measured pre- and postoperatively. Results: The preoperative hearing thresholds ranged from 10 to 25 dB HL, while postoperative from 25 to 65 dB HL at the whole frequency band 0,125 –8 kHz. In the postoperative speech audiometry the speech understanding reached 65%. The median value for ABR wave V latency prolongation was 1,38 ms while for the AP latency 0,23 ms. AP amplitude has been reduced by 1.43 μV. Conclusion: The analyzed material presents significant correlation between hearing threshold and the parameters characterizing the hearing physiology of the ABR wave V latency, the amplitude reduction and the AP latency prolongation. The above proves the usefulness of IM in VS removal surgeries.
EN
Objective: The aim of this study is to present a methodology of vestibular evoked myogenic potentials registered from sternocleidomastoid muscle (SCM) using skull tap stimulation (Tap-cVEMP) in a patient with cerebellopontine angle tumor (CPAT). Material and methods: A 23-year-old female with CPAT. The methodology of Tap-cVEMP is introduced. The results of VEMP is confronted with surgical information about the tumor. Results: The results of AC-cVEMP and Tap-cVEMP revealed the inferior vestibular nerve bundle to be affected by the tumor with intact superior bundle. Information obtained from VEMP was confirmed during surgery. Conclusion: Skull Tap Vestibular Evoked Myogenic Potentials (Tap-cVEMP) may be the useful method in the diagnostics of CPAT. AC-cVEMP and Tap-cVEMP may be helpful to evaluate the functional integrity of both vestibular nerve bundles providing the information about their involvement in the pathological process.
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