Early diagnosis of acoustic neuroma (1989) after experience of 37 cases.
Although the diagnosis of acoustic neuroma as classically described is generally thought to be easy, this is not always true for this so-called "ear tumor" which is localized within the internal auditory meatus. Recently, remarkable progress has been made in the diagnostic instrumentation and operative techniques used to treat acoustic neuroma, emphasizing the need for early diagnosis so that treatment can take place earlier than before. Through early diagnosis, some cases of total resection of acoustic neuroma have recently become possible, with preservation of not only facial nerve function, but preservation of auditory function as well. In the present report, we outline the early diagnosis of acoustic neuroma by summarizing 37 cases of acoustic neuroma experienced at our institution. We discuss historical presentations, and laboratory tests used in diagnosis including pure tone audiometry, speech audiometry, auditory brainstem evoked response (ABR), vestibular caloric stimulation, and computed tomography (CT) enhanced by introduction of air into the posterior fossa. Two representative cases are also presented. It should be emphasized that no clinical test is 100% sensitive or specific, and attention must be paid to chronological discrepancies in the patient's presentation and "cookbook"-type approaches to evaluation should be avoided.
Sakata
E
E
Department of Neurotology, Saitama Medical School, Japan.
Ohtsu
K
K
Itoh
Y
Y
Teramoto
K
K
D000328:Adult; D001300:Audiometry, Evoked Response / Q000592:standards; D001301:Audiometry, Pure-Tone / Q000592:standards; D002150:Caloric Tests; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009464:Neuroma, Acoustic / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000453:epidemiology; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000592:standards