Vestibular Function In Vestibular Schwannoma

Introduction: Traditionally vestibular function has been assessed using caloric irrigations; new methods have failed to reach the same level of accuracy. Vestibular nerve dysfunction occurs with 'acoustic neuroma' or 'vestibular schwannoma. Quantitative testing of hearing by audiometry is much more widely available than quantitative vestibular testing, although consideration of vestibular dysfunction is part of clinical management. Validation of a new method of quantitative vestibular function testing could lead to more widespread integration into clinical practice and affect decision making (i.e. timing of surgery) Methods: A non-blind observational cohort study was undertaken in 31 participants. Study endpoints were either one or two separate participant measures in March/April 2013 the September/October 13. All participants underwent caloric and head impulse testing with video-oculography, while 10 underwent audiometric assessment. Repeat testing was performed for 10 subjects, including additional cognitive. The primary outcome was vestibular function test measures. Results: Video head impulse was strongly correlated with calorics (p=0.01) and showed good sensitivity (80%) and specificity (70%). Dizziness Handicap Inventory showed no correlation with other vestibular function measures. Participants showed reduced cognitive function tested using the CANTAB battery (p=0.01) Conclusion: Video head impulse testing is comparable to caloric testing to assess vestibular function. Vestibular lesions may lead to cognitive deficits. Further research is needed to better understand the role of video head impulse testing in vestibular schwannoma. III Acknowledgements Firstly, I would like to acknowledge my supervisors Dr. Nick Cutfield, A/Prof Patrick Dawes and A/Prof Cynthia Darlington. Each, in their own way, has contributed hugely to this project, and without them I would undoubtedly still be working on it. Thank you for taking the time to teach an often somewhat befuddled student. Thank you to Prof. Paul Smith, whose passion for statistics is catching. Thirdly, I have to thank the Department of Medicine and everyone who has made my time there so enjoyable. Above all I would like to thank the participants, without them there would be no study. Finally, to my family thank you for all your love and support. Especially Sarah and Peter.