Early diagnosis of acoustic neuroma by the vestibular tests. Indication for computerized tomography and cisternomeatography
Haid, T.; Rettinger, G.; Berg, M.; Wigand, M.E.
Hno 29(11): 357-363
1981
ISSN/ISBN: 0017-6192 PMID: 7309580 Document Number: 179162
In a series of 390 cases with suspicion of acoustic neurinomas 78 such tumors could be diagnosed, including 12 early stage neurinomas. This relatively high detection quote of small neurinomas is due to a special diagnostical program: every patient with unilateral and sensoneural hearingloss, independent of vertigo anamnesis or of the result of X-rays must be further examined by a vestibular test. All 78 patients with acoustic neuroma had pathological vestibular findings. The positional test turned out to be the most sensitive examination in the early diagnosis of acoustic neuromas and yields a still higher incidence than the thermic test: 95% of the patients with a neuroma showed pathological findings in the positional test. Every patient suffering from an unidentified unilateral and sensoneural hearing loss combined with a pathological result in the positional test must be further checked by cisternomeatography or computerized tomography using air insufflation. Every fifth of these patients showed typical signs of an acoustic neuroma in the neuroradiological tests. Neuromas (68) are operated today and verified histologically, 10 patients are still waiting for surgical treatment.