Normal hearing in acoustic neuroma patients: a critical evaluation.
A series of 128 acoustic neuromas (ANs) managed in our center in the last 6 years were evaluated. Sixteen cases (12.5%) were found to have normal pure tone audiograms. A comparatively younger age was an important characteristic of these patients. Tinnitus, dysequilibrium, and subjective hearing loss or distortion were their most common complaints. Pure tone audiometry showed a mean pure tone average of 14.5 dB. Speech discrimination score and performance intensity phonetically balanced index were very insensitive and showed very high false-negative results. Auditory brainstem responses proved to be a reliable test, being positive in 93.8% of cases. The mean tumor size did not show any significant difference when compared with acoustic neuroma cases with abnormal hearing. The combination of otologic and neurotologic symptoms in a young patient should prompt the clinician to investigation further even if hearing is within normal limits. A high index of suspicion is a prerequisite for the early diagnosis of such subtle lesions.
Saleh
E A
EA
Department of Otolaryngology, Alexandria School of Medicine, Egypt.
Aristegui
M
M
Naguib
M B
MB
Cokesser
Y
Y
Landolfi
M
M
Sanna
M
M
D000328:Adult; D001301:Audiometry, Pure-Tone; D003390:Cranial Nerve Neoplasms / Q000473:pathology* / Q000601:surgery; D016057:Evoked Potentials, Auditory, Brain Stem; D005260:Female; D006309:Hearing / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009464:Neuroma, Acoustic / Q000473:pathology* / Q000601:surgery; D012189:Retrospective Studies; D013063:Speech Discrimination Tests; D000159:Vestibulocochlear Nerve / Q000473:pathology* / Q000601:surgery