The Diagnostic Accuracy of Non-Imaging Screening Protocols for Vestibular Schwannoma in Patients With Asymmetrical Hearing Loss and/or Unilateral Audiovestibular Dysfunction: A Diagnostic Review and Meta-Analysis
Clinical Otolaryngology
Hentschel, M., Scholte, M., et al. (2017).
Clinical Otolaryngology, 42(4), 815-823.
This systematic review and meta-analysis investigates the accuracy of non-imaging audiometric assessment methods (e.g., pure-tone audiometry, auditory brainstem response, electronystagmography) for the screening and identification of vestibular schwannoma in patients with asymmetrical sensorineural hearing loss and/or unilateral vestibular dysfunction.
Netherlands Organization for Health Research and Development (ZonMw)
Up to July 28, 2016
Original prospective and retrospective diagnostic study designs
12
<div>Studies investigating the use of electronystagmography (ENG) and caloric irrigation to identify vestibular schwannoma in patients were limited. ENG had a sensitivity of 70% (i.e., true positive) and specificity of 48% (i.e., true negative). Caloric irrigation had a sensitivity of 43% and specificity of 91%.</div>
<div>Studies investigating the accuracy of the auditory brainstem response (ABR) for identification of patients with vestibular schwannoma were heterogeneous and not capable of meta-analysis. Studies reported wide variation in sensitivity (37% to 100%) and specificity (57% to 96%) for the use of ABR alone in identifying vestibular schwannoma. </div>
<div>Various pure-tone audiometry protocols demonstrated high sensitivity for correctly identifying 91% of patients with vestibular schwannoma, but protocols had low specificity values. Additionally, 9% of patients with vestibular schwannoma would be missed using the pure-tone audiometry protocols alone.</div>
