title: [Diagnosis of Cochleovestibular Neurovascular Compression Syndrome:A Scoring System Based on Five Clinical Characteristics].
abstract: The optimal method for diagnosing cochleovestibular neurovascular compression syndrome(CNVC)remains controversial, and the aim of this study is to develop a standard diagnostic instrument for the condition. The clinical features of 53 sides of 50 patients with a combination of vertigo, tinnitus, and/or hearing loss were retrospectively evaluated. The following five clinical features were evaluated and given a score of 1 or 0:1)a long history of recurrent vertigo, tinnitus, or hearing loss;2)neurological findings related to positional vertigo, nystagmus, tinnitus, or hearing loss;3)neuro-otological findings involving tinnitus, audiometry, or vestibular testing;4)auditory brainstem response(ABR)evaluation with the detection of a low 25-75% II wave amplitude on the contralateral side and delayed interpeak latency in the I-III or I-V waves(usually low II wave amplitude combined with double peaks and a wide-based form)during ABR evaluation using 80 and 90dB clicks;and 5)the detection of vascular contact with the eighth cranial nerve on magnetic resonance imaging-constructive interference in steady state or air computed tomography imaging. Finally, the sum of these scores was evaluated. For cases in which more than one of the features of the items 1), 2), or 3) were present, the score was evaluated based on the most representative of the items.
  
  
  RESULTS
  The patients were divided into those with scores of 4-5 and those with scores of 2-3. All the patients with scores of 4-5 exhibited CNVC, while those with scores of 2-3 had other diseases. Therefore, CNVC should be suspected in patients with scores of 4-5, but can be ruled out in those with scores of 2-3.
authors.affiliation: Department of Neurosurgery, Ube Industries Central Hospital.
authors.forename: Tomomi
authors.initials: T
authors.lastname: Okamura
authors.forename: Takafumi
authors.initials: T
authors.lastname: Nishizaki
authors.forename: Norio
authors.initials: N
authors.lastname: Ikeda
authors.forename: Shigeki
authors.initials: S
authors.lastname: Nakano
authors.forename: Takanori
authors.initials: T
authors.lastname: Sakakura
authors.forename: Natsumi
authors.initials: N
authors.lastname: Fujii
authors.forename: Takeshi
authors.initials: T
authors.lastname: Okuda
mesh_terms: D000328:Adult; D000368:Aged; D016057:Evoked Potentials, Auditory, Brain Stem / Q000502:physiology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D009408:Nerve Compression Syndromes / Q000175:diagnosis* / Q000473:pathology; D012189:Retrospective Studies; D014012:Tinnitus / Q000175:diagnosis* / Q000473:pathology; D014717:Vertigo / Q000175:diagnosis* / Q000473:pathology