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.

Overview

Symptoms of acoustic neuroma may vary depending on the cranial nerve involvement, cerebellar compression, mass size and tumor progression. hearing loss and tinnitus almost always are seen in cochlear nerve involvement, while unsteadiness is common among patients with involvement of the vestibular nerve. Trigeminal nerve involvement occurs among one-sixth of patients and usually presents with facial paresthesia or hypesthesia. Facial paresis, taste disturbances, xerophthalmia, paroxysmal lacrimation, and xerostomia are less common symptoms which may present due to involvement of the facial nerve.

History and Symptoms

Symptoms of acoustic neuroma may vary depending on the cranial nerve involvement, cerebellar compression, mass size and tumor progression. hearing loss and tinnitus almost always are seen in cochlear nerve involvement, while unsteadiness is common among patients with involvement of the vestibular nerve. Trigeminal nerve involvement occurs among one-sixth of patients and usually presents with facial paresthesia or hypesthesia. Facial paresis, taste disturbances, xerophthalmia, paroxysmal lacrimation, and xerostomia are less common symptoms which may present due to involvement of the facial nerve.[1][2][3][4][5]

History

  • Chronic gradual unilateral hearing impairment is the most common symptom presents in 95 percent of patients. Average symptom duration is about four years. The hearing impairment usually presents in chronic, however infrequently acoustic neuroma may present with sudden sensorineural hearing loss. Tinnitus is associated symptom among patients with the involvement of cochlear nerve.[6]
  • Approximately 50% of patients with acoustic neuroma report disequilibrium and sense of unsteadiness while walking. True spinning vertigo is not common presenting symptoms among patients with acoustic neuroma.

Common Symptoms

Less Common Symptoms

The below table summarize information about the frequency of major symptoms and signs of acoustic neuroma:[7][2][8][9][10]

Major signs and symptoms Diagnostic accuracy of clinical features in predicting the tumor progress
Signs and symptoms Frequency Sensitivity Specificity
Hypacusis (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

  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)
  2. 2.0 2.1 Hart, Robert G.; Davenport, John (1981). "Diagnosis of Acoustic Neuroma". Neurosurgery. 9 (4): 450–463. doi:10.1227/00006123-198110000-00021. ISSN 0148-396X.
  3. 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)
  4. 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)
  5. 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)
  6. 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)
  7. 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)
  8. 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)
  9. 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)
  10. 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)

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