DASHBOARD

STATISTICSREVIEW TEXTBOOK START REVISING

← Back to Search Results Cranial Nerve VIII: Vestibulocochlear Nerve LAST UPDATED: 20TH AUGUST 2019

ANATOMY / CRANIAL NERVE LESIONS / HEAD AND NECK / EAR  Bookmark

SEARCH TEXTBOOK

Search textbook...
The vestibulocochlear nerve (CN VIII) is a sensory nerve which transmits sensory information regarding head position and movement via the
vestibular nerve, and regarding the reception of sound via the cochlear nerve.

Cranial Nerve VIII: Table: Overview of the Vestibulocochlear Nerve

Vestibulocochlear Nerve
Anatomy Cranial Vestibulocochlear Nerve (CN VIII)
FRCEM Success Nerve

Key anatomy Comprised of vestibular and cochlear components which combine in the pons, emerges from the brainstem at the
cerebellopontine angle, enters internal acoustic meatus of temporal bone

Function Sensory: hearing and balance

Assessment Hearing, Weber and Rinne tests

Clinical Sensorineural deafness, tinnitus, vertigo, loss of equilibrium, nystagmus

e ects of
injury

KEYWORDS Causes of Infection, cerebellopontine angle tumours, basal skull fracture, drugs
Cranial Nerves Vestibulocochlear Nerve injury

RELATED TOPICS
Anatomical Course
Anatomy Head and Neck

Cranial Nerve Lesions Ear The vestibulocochlear nerve is comprised of two parts. The vestibular and cochlear component combine in the pons to form the
vestibulocochlear nerve which emerges from the brainstem at the cerebellopontine angle to enter the internal acoustic meatus of the temporal
bone. Within the distal aspect of the internal acoustic meatus, the vestibulocochlear nerve splits, forming the vestibular nerve innervating the
Something wrong?
vestibular system and the cochlear nerve innervating the cochlear.

VESTIBULOCOCHLEAR N ERVE. (IMAGE BY ZIN A DERETSKY, NATIONAL SCIENCE FOUNDATIO N [P UBL IC DO MAIN] , V IA W IKIME DIA CO MMO N S)

Assessment

The vestibulocochlear nerve can be assessed by:

Testing hearing by whispering numbers into each ear separately and asking the patient to repeat it
Performing Rinne and Weber tuning fork tests to di erentiate between conductive and sensorineural hearing loss

Table: Rinne and Weber Tuning Fork Tests

Tuning Fork Test Weber’s test Rinne’s test

Screening Test of lateralisation to assess for Test of comparison of perceived air conduction to bone conduction to
asymmetric conductive or assess for conductive hearing loss.
sensorineural hearing loss.

Method Strike tuning fork, place on midline of
forehead and hold for up to 4 s. Ask
patient to report where the tone is
heard: centrally (in the head or in both
ears) or towards the left or right.
Start with ear that Weber test has lateralised to. Strike tuning fork and
hold about 25 mm from ear canal entrance for about 2 s. Immediately
then place against the mastoid and hold for a further 2 s. Ask patient to
report whether tone is louder next to the ear (Air conduction: AC) or
behind the ear (Bone conduction: BC).

Normal hearing Sound is heard centrally. AC > BC in both ears (Rinne positive).

Unilateral Sound lateralised to a ected ear. In a ected ear BC > AC (Rinne negative).
conductive hearing
loss In una ected ear AC > BC (Rinne positive).

Unilateral Sound lateralised to una ected ear. In a ected ear AC > BC (Rinne positive).
sensorineural
hearing loss In una ected ear AC > BC (Rinne positive).

Bilateral hearing Sound is heard centrally. Sensorineural: AC > BC in both ears (Rinne positive).
loss
Conductive: BC > AC in both ears (Rinne negative).

Likely Causes of Disease or Injury

Possible causes of damage to the vestibulocochlear nerve include:

Infections e.g. vestibular neuritis, mastoiditis and herpes zoster

Cerebellopontine angle tumours (85% are acoustic neuromas, others include meningiomas, cholesteatomas and primary malignancies of
the posterior fossa)
Tumours invading the temporal bone e.g. brainstem glioma
Vascular malformations at the cerebellopontine angle
Drugs e.g. aspirin, furosemide, phenytoin, cytotoxics, alcohol
Paget's disease
Fracture of the petrous temporal bone
Basal skull fracture

Common Clinical E ects

Damage to the vestibulocochlear nerve results in (ipsilateral):

Sensorineural deafness
Tinnitus
Loss of equilibrium
Nystagmus
Vertigo