Acoustic neuroma physical examination: Difference between revisions

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{{Acoustic neuroma}}
{{Acoustic neuroma}}
{{CMG}}
{{CMG}}{{AE}}{{Sab}}{{Simrat}}
==Overview==
==Overview==
[[Patient|Patients]] with acoustic neuroma usually appear normal. [[Physical examination]] of [[Patient|patients]] with acoustic neuroma is usually remarkable for [[Sensorineural hearing loss]] in the affected [[ear]], positive [[Rinne test]], abnormal [[Weber test]], [[Papilledema]], [[Nystagmus]], [[Diplopia]] on [[lateral]] gaze, decreased or absent [[ipsilateral]] [[corneal]] [[reflex]], [[Face|facial]] [[twitching]] or [[hypesthesia]], [[Drooling]], [[Facial paralysis|drooping on one side of the face]], loss of taste, and [[ataxia]].


==Physical Examination==
==Physical Examination==
===Appearance of the Patient===
* [[Patient|Patients]] with acoustic neuroma usually appear normal.


Often, the physical exam is normal at the time the tumor is diagnosed. Occasionally, the following signs may be present:
===Vital Signs===
* [[Vital signs]] of [[patients]] with acoustic neuroma are usually within normal limits.


* Drooling(VII nerve involvement)
===Skin===
* Facial drooping on one side(VII nerve involvement)
* [[Skin]] [[Physical examination|examination]] of [[Patient|patients]] with acoustic neuroma is usually normal.
* Unsteady walk(Vestibulococchlear involvement)
 
* Dilated pupil on one side only
===HEENT===
* Caloric stimulation test may be abnormal.
*[[Sensorineural hearing loss]] in the affected [[ear]]<ref>{{Cite journal
| author = [[Robert W. Foley]], [[Shahram Shirazi]], [[Robert M. Maweni]], [[Kay Walsh]], [[Rory McConn Walsh]], [[Mohsen Javadpour]] & [[Daniel Rawluk]]
| title = Signs and Symptoms of Acoustic Neuroma at Initial Presentation: An Exploratory Analysis
| journal = [[Cureus]]
| volume = 9
| issue = 11
| pages = e1846
| year = 2017
| month = November
| doi = 10.7759/cureus.1846
| pmid = 29348989
}}</ref><ref>{{Cite journal
| author = [[Xiang Huang]], [[Jian Xu]], [[Ming Xu]], [[Liang-Fu Zhou]], [[Rong Zhang]], [[Liqin Lang]], [[Qiwu Xu]], [[Ping Zhong]], [[Mingyu Chen]], [[Ying Wang]] & [[Zhenyu Zhang]]
| title = Clinical features of intracranial vestibular schwannomas
| journal = [[Oncology letters]]
| volume = 5
| issue = 1
| pages = 57–62
| year = 2013
| month = January
| doi = 10.3892/ol.2012.1011
| pmid = 23255894
}}</ref><ref>{{Cite journal
| author = [[C. Matthies]] & [[M. Samii]]
| title = Management of 1000 vestibular schwannomas (acoustic neuromas): clinical presentation
| journal = [[Neurosurgery]]
| volume = 40
| issue = 1
| pages = 1–9
| year = 1997
| month = January
| pmid = 8971818
}}</ref>
*Positive [[Rinne test]]
*[[Weber test]] lateralizes to normal [[ear]]
 
*[[Nystagmus]]
 
*[[Papilledema]]
*[[Diplopia]] on [[lateral]] gaze
 
===Neck===
* [[Neck]] [[Physical examination|examination]] of [[Patient|patients]] with acoustic neuroma is usually normal.
 
===Lungs===
* [[Respiratory examination|Pulmonary examination]] of [[Patient|patients]] with acoustic neuroma is usually normal.
 
===Heart===
* [[Circulatory system|Cardiovascular]] [[Physical examination|examination]] of [[Patient|patients]] with acoustic neuroma is usually normal.
 
===Abdomen===
* [[Abdominal examination]] of [[Patient|patients]] with acoustic neuroma is usually normal.
 
=== Back ===
* [[Human back|Back]] [[Physical examination|examination]] of [[Patient|patients]] with acoustic neuroma is usually normal.
 
=== Genitourinary ===
* [[Genitourinary system|Genitourinary]] [[Physical examination|examination]] of [[Patient|patients]] with acoustic neuroma is usually normal.
 
===Neuromuscular===
*[[Trigeminal nerve|Cranial nerve V]]- Decreased or absent [[ipsilateral]] [[corneal]] [[reflex]].
*[[Facial nerve|Cranial nerve VII]]- [[Face|Facial]] [[twitching]] or [[hypesthesia]], [[Drooling]], [[Facial paralysis|drooping on one side of the face]], and loss of taste
*[[Vestibulocochlear nerve|Cranial nerve VIII]]- Positive [[Rinne test]] and abnormal [[Weber test]]
*[[Glossopharyngeal nerve|Cranial nerve IX]]- Loss of taste in the [[Anatomical terms of location|posterior]] half of [[tongue]]
*[[Cerebellum]]- [[Ataxia]]
 
=== Extremities ===
* [[Limb (anatomy)|Extremities]] [[Physical examination|examination]] of [[Patient|patients]] with acoustic neuroma is usually normal.


==References==
==References==
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[[Category:Types of cancer]]
[[Category:Disease]]
[[Category:Up-To-Date]]
[[Category:Oncology]]
[[Category:Medicine]]
[[Category:Otolaryngology]]
[[Category:Neurology]]
[[Category:Neurosurgery]]

Latest revision as of 19:45, 26 April 2019

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Sabawoon Mirwais, M.B.B.S, M.D.[2]Simrat Sarai, M.D. [3]

Overview

Patients with acoustic neuroma usually appear normal. Physical examination of patients with acoustic neuroma is usually remarkable for Sensorineural hearing loss in the affected ear, positive Rinne test, abnormal Weber test, Papilledema, Nystagmus, Diplopia on lateral gaze, decreased or absent ipsilateral corneal reflex, facial twitching or hypesthesia, Drooling, drooping on one side of the face, loss of taste, and ataxia.

Physical Examination

Appearance of the Patient

  • Patients with acoustic neuroma usually appear normal.

Vital Signs

Skin

HEENT

Neck

Lungs

Heart

Abdomen

Back

Genitourinary

Neuromuscular

Extremities

References

  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)
  2. ↑ 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)
  3. ↑ 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)

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