Acoustic neuroma history and symptoms
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Mohsen Basiri M.D.Sabawoon Mirwais, M.B.B.S, M.D.[2]
Overview
Chronic gradual unilateral hearing impairment is the most common complaint present in 95% of the patients. Common symptoms include chronic gradual unilateral hearing loss, ringing in the ear, Disequilibrium, facial numbness, facial pain, and Headache. Less common symptoms include facial muscle weakness, taste disturbances, dryness of the eyes, sudden lacrimation, speech problem, difficulty swallowing, aspiration, hoarseness, and ear pain.
History and Symptoms
History
- Chronic gradual unilateral hearing impairment is the most common complaint present in 95% of the patients.
- The hearing impairment usually occurs in patients with longstanding disease but acoustic neuroma may also present with sudden sensorineural hearing loss.
- Ringing in the ear (tinnitus) is an associated complaint among patients with the involvement of cochlear nerve.[1]
- Approximately 50% of patients with acoustic neuroma report disequilibrium and sense of unsteadiness while walking.
Common Symptoms
- Chronic gradual unilateral hearing loss[2][3][4][5][6]
- Ringing in the ear
- Disequilibrium
- Facial numbness
- Facial pain
- Headache
Less Common Symptoms
- Facial muscle weakness[2][3][4][5][6]
- Taste disturbances
- Dryness of the eyes
- Sudden lacrimation
- Dryness of mouth
- Speech problem
- Difficulty swallowing
- Aspiration
- Hoarseness
- Ear pain
The below table summarize information about the frequency of major symptoms and signs of acoustic neuroma:[7][3][8][9][10]
| Major signs and symptoms | Diagnostic accuracy of clinical features in predicting the tumor progress | ||
|---|---|---|---|
| Signs and symptoms | Frequency | Sensitivity | Specificity |
| Hypoacusis (hearing impairment) | The most common | High | low |
| Facial paresthesia | Commonly seen | Moderate | Moderate |
| Instability of gait | |||
| Tinnitus | |||
| Hearing loss (deafness) | Occasionally seen | low | high |
| Headache | |||
| Facial paralysis | |||
| Vertigo | |||
| Absent corneal reflex | |||
| Bucking | Rarely seen | Very low | Very high |
| Visual disorder | |||
| Nausea and vomiting | |||
| Nystagmus | |||
| Movement disorder | |||
| Mastication disorder | |||
| Romberg sign | |||
| Hoarseness | |||
| Abduction disorder | |||
| Ear pain | |||
References
- ↑ Eric E. Smouha, Michael Yoo, Kristi Mohr & Raphael P. Davis (2005). "Conservative management of acoustic neuroma: a meta-analysis and proposed treatment algorithm". The Laryngoscope. 115 (3): 450–454. doi:10.1097/01.mlg.0000175681.52517.cf. PMID 15744156. Unknown parameter
|month=ignored (help) - ↑ 2.0 2.1 C. Matthies & M. Samii (1997). "Management of 1000 vestibular schwannomas (acoustic neuromas): clinical presentation". Neurosurgery. 40 (1): 1–9. PMID 8971818. Unknown parameter
|month=ignored (help) - ↑ 3.0 3.1 3.2 Hart, Robert G.; Davenport, John (1981). "Diagnosis of Acoustic Neuroma". Neurosurgery. 9 (4): 450–463. doi:10.1227/00006123-198110000-00021. ISSN 0148-396X.
- ↑ 4.0 4.1 Xiang Huang, Jian Xu, Ming Xu, Liang-Fu Zhou, Rong Zhang, Liqin Lang, Qiwu Xu, Ping Zhong, Mingyu Chen, Ying Wang & Zhenyu Zhang (2013). "Clinical features of intracranial vestibular schwannomas". Oncology letters. 5 (1): 57–62. doi:10.3892/ol.2012.1011. PMID 23255894. Unknown parameter
|month=ignored (help) - ↑ 5.0 5.1 Robert W. Foley, Shahram Shirazi, Robert M. Maweni, Kay Walsh, Rory McConn Walsh, Mohsen Javadpour & Daniel Rawluk (2017). "Signs and Symptoms of Acoustic Neuroma at Initial Presentation: An Exploratory Analysis". Cureus. 9 (11): e1846. doi:10.7759/cureus.1846. PMID 29348989. Unknown parameter
|month=ignored (help) - ↑ 6.0 6.1 L. R. Lustig, S. Rifkin, R. K. Jackler & L. H. Pitts (1998). "Acoustic neuromas presenting with normal or symmetrical hearing: factors associated with diagnosis and outcome". The American journal of otology. 19 (2): 212–218. PMID 9520059. Unknown parameter
|month=ignored (help) - ↑ C. Matthies & M. Samii (1997). "Management of 1000 vestibular schwannomas (acoustic neuromas): clinical presentation". Neurosurgery. 40 (1): 1–9. PMID 8971818. Unknown parameter
|month=ignored (help) - ↑ Xiang Huang, Jian Xu, Ming Xu, Liang-Fu Zhou, Rong Zhang, Liqin Lang, Qiwu Xu, Ping Zhong, Mingyu Chen, Ying Wang & Zhenyu Zhang (2013). "Clinical features of intracranial vestibular schwannomas". Oncology letters. 5 (1): 57–62. doi:10.3892/ol.2012.1011. PMID 23255894. Unknown parameter
|month=ignored (help) - ↑ Robert W. Foley, Shahram Shirazi, Robert M. Maweni, Kay Walsh, Rory McConn Walsh, Mohsen Javadpour & Daniel Rawluk (2017). "Signs and Symptoms of Acoustic Neuroma at Initial Presentation: An Exploratory Analysis". Cureus. 9 (11): e1846. doi:10.7759/cureus.1846. PMID 29348989. Unknown parameter
|month=ignored (help) - ↑ L. R. Lustig, S. Rifkin, R. K. Jackler & L. H. Pitts (1998). "Acoustic neuromas presenting with normal or symmetrical hearing: factors associated with diagnosis and outcome". The American journal of otology. 19 (2): 212–218. PMID 9520059. Unknown parameter
|month=ignored (help)