Audio-Vestibular Profiling and Rehabilitation Option for Vestibular Schwannomas - A Case Study

Introduction:The balance and hearing nerves that supply the inner ear can develop into benign, slow-growing tumors called vestibular schwannomas (VS), sometimes known as acoustic neuromas, acoustic neurinomas, or acoustic neurilemomas.Case Report: A 70-year-old male subject reported to the clinic with a complaint of reduced hearing sensitivity in the left ear for 4-5 months in situations where competing stimuli are present (background noise, group discussion, etc.) with vertigo since last 3 month. Diagnosis:The PTA revealed Mild sensorineural hearing loss (PTA:33.3dBHL) in the right ear and Moderate tending to moderately severe high-frequency sloping sensorineural hearing loss (PTA:51.6 dBHL) in the left ear.SISI revealed a score of 10% in both the ears at 500 Hz, 1KHz and 2KHz frequencies which suggestive of no cochlear pathology.Tone decay test revealed decay of less than 30 dBHL suggesting no Retro Cochlear Pathology in the right ear while the decay of >30 dBHL at 1K Hz and 2 KHz suggestive of retro cochlear pathology in the left ear.OAE is absent in the left ear.ABR was absent in the left ear at a slow and high stimulus rate.Contralateral ABR was also absent due to mass effect.No peak was obtained in the left ear in OVEMP. Conclusion:The sensitivity of each test varies from person to person based on the size of tumor and the location of the tumour.Test battery approach is the best way to differentiate the pathology.A combination of radiological and audiovestibular assessment will provide a better picture about vestibular schwannomas.