The Journal of Laryngology & Otology

Main Article

Vestibular schwannoma: when to look for it?

S Gimsinga1 c1

a1 Department of Audiology, Vejle Hospital, Denmark


Objectives: (1) To compare audiometric parameters in patients with vestibular schwannoma and in those with asymmetric hearing loss from other causes; and (2) to assess proposed screening criteria by comparing published protocols.

Methods: Audiometric data from 199 vestibular schwannoma patients and 225 non-tumour patients were compared. Eight screening protocols were tested on these 424 patients.

Results: Vestibular schwannoma and non-tumour patients with little or no hearing loss in the unaffected ear were inseparable; however, vestibular schwannoma patients with hearing loss in the unaffected ear had greater audiometric asymmetry, compared with non-tumour patients with the same pattern of hearing loss. The sensitivity of screening protocols varied from 73 to 100 per cent; parallelism was observed between sensitivity and screening rate.

Conclusion: As regards vestibular schwannoma screening protocols, the best compromise between sensitivity and screening rate was offered by a criterion comprising either: (1) ≥20 dB asymmetry at two neighbouring frequencies, or unilateral tinnitus, or (2) ≥15 dB asymmetry at two frequencies between 2 and 8 kHz.

(Accepted June 15 2009)

(Online publication November 19 2009)


c1 Address for correspondence: Dr Steen Gimsing, Department of Audiology, Vejle Hospital, DK-7100 Denmark. E-mail:


Dr S Gimsing takes responsibility for the integrity of the content of the paper.

Competing interests: None declared