Preoperative versus postoperative role of vestibular-evoked myogenic potentials in cerebellopontine angle tumor

Abstract

Objective/hypothesis: Vestibular-evoked myogenic potential (VEMP) examination was performed on patients with a cerebellopontine angle (CPA) tumor to evaluate its clinical role.

Methods: Patients with a CPA tumor were subjected to caloric test and VEMP examination. Follow-up study was performed 1 year after the surgery.

Results: Six (69%) of the 9 tumors did not exhibit either caloric response or VEMP on the lesioned side. Three patients received tumor excision and all tumors involved both the superior and inferior vestibular nerves. Two (22%) of the 9 tumors had normal caloric responses but no VEMP. One underwent surgical excision, and the tumor originated from the inferior vestibular nerve. In the follow-up study, only 1 patient with epidermoid cyst presented complete recovery of caloric response and VEMP, whereas in the other 3 patients with vestibular schwannoma, the responses were all absent persistently.

Conclusion: Before surgery, VEMP test can be used to predict the nerve of origin and to formulate the best surgical approach. After surgery, VEMP test can be used to define the nature of the tumor (compressing or infiltrating the nerve) and disclose the residual function of the inferior vestibular nerve.