title: [Discrimination of Hearing Disorder by Means of CLS and OAE in Vestibular Schwannoma].
abstract: BACKGROUND
  Currently a sensitive early diagnosis of small vestibular schwannoma is only possible by using magnetic resonance imaging (MRI).
  
  
  OBJECTIVE
  The main objective was a differentiation of the cochlear and retrocochlear component of small vestibular schwannoma with the help of categorial loudness scaling (CLS) and the growth function of otoacoustic emissions (DPOAE I/O-functions).
  
  
  METHODS
  34 patients (gr. 1: 17 patients with vestibular schwannoma ≤15 mm, gr. 2: 17 matched patients with an inner ear hearing disorder) were examined. Besides audiological standard procedures they also underwent CLS according to the Würzburger auditory field and a generation of DPOAE I/O-functions was conducted on the probands.
  
  
  RESULTS
  The gradients of the loudness growth function as part of the CLS and the DPOAE I/O-functions showed with few exceptions [500 Hz at 0-10 dB HL during CLS (p=0,040)] no significant differences between the groups (all p>0.05). A recruitment verification with the help of CLS was possible for tumors starting at a size of 5.45,mm at 3,000 and 4,000 Hz, respectively for tumors exceeding the size of 6.85 mm at 6,000 Hz with 100% sensitivity but only low specificity.
  
  
  CONCLUSIONS
  A differentiation between a vestibular schwannoma and a mere cochlear hearing disorder with only the help of CLS and DPOAE I/O-functions is not possible. The results corroborate the thesis of an additional cochlear component even in small vestibular schwannoma. The implementation of CLS to determine cochlear deficits linked to vestibular schwannoma seems to be medically sensible if the tumor size exceeds 5 mm. According to the diagnostic method used to determine vestibular schwannoma MRI remains the first choice procedure.
authors.affiliation: Klinik für Hals-, Nasen-, Ohrenheilkunde, Plastische Operationen, HELIOS Klinikum GmbH, Erfurt.
authors.forename: E
authors.initials: E
authors.lastname: Börner
authors.affiliation: Klinik und Poliklinik für HNO-Heilkunde, HNO, Universitätsklinikum Jena, Jena.
authors.forename: O
authors.initials: O
authors.lastname: Guntinas-Lichius
authors.affiliation: Klinik für Hals-, Nasen-, Ohrenheilkunde, Plastische Operationen, HELIOS Klinikum GmbH, Erfurt.
authors.forename: D
authors.initials: D
authors.lastname: Eßer
authors.affiliation: Klinik für Hals-, Nasen-, Ohrenheilkunde, Plastische Operationen, HELIOS Klinikum GmbH, Erfurt.
authors.forename: I
authors.initials: I
authors.lastname: Baljić
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001301:Audiometry, Pure-Tone; D001309:Auditory Threshold; D005260:Female; D006319:Hearing Loss, Sensorineural / Q000175:diagnosis*; D006801:Humans; D012001:Hyperacusis; D008144:Loudness Perception; D008297:Male; D008875:Middle Aged; D009464:Neuroma, Acoustic / Q000175:diagnosis*; D017084:Otoacoustic Emissions, Spontaneous; D055815:Young Adult