Acoustic neuroma history and symptoms: Difference between revisions

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{{Acoustic neuroma}}
{{Acoustic neuroma}}
{{CMG}}{{AE}}{{Simrat}}
{{CMG}}{{AE}}{{M.B}}{{Sab}}
==Overview==
==Overview==
Symptoms of acoustic neuroma include [[hearing loss]], [[tinnitus]], [[vertigo]], [[headaches]], [[facial weakness]], facial [[numbness]] and [[tingling]], [[dizziness]], taste changes, difficulty swallowing and [[hoarseness]] and, [[confusion]].<ref name="wiki">Vestibular Schwannoma. Wikipedia(2015) https://en.wikipedia.org/wiki/Vestibular_schwannoma Accessed on October 2 2015</ref>
Chronic gradual unilateral [[hearing impairment]] is the most common complaint present in 95% of the [[Patient|patients]]. Common [[Symptom|symptoms]] include chronic gradual unilateral [[Hearing impairment|hearing loss]], ringing in the [[ear]], [[Disequilibrium]], [[Face|facial]] [[Paresthesia|numbness]], [[Face|facial]] [[pain]], and [[Headache]]. Less common [[Symptom|symptoms]] include [[Face|facial]] [[muscle weakness]], [[Taste alteration|taste disturbances]], [[Xerophthalmia|dryness of the eyes]], sudden [[Tears|lacrimation]], [[Dysarthria|speech problem]], [[Dysphagia|difficulty swallowing]], [[Aspiration (medicine)|aspiration]], [[Dysphonia|hoarseness]], and [[Otalgia|ear pain]].


==Symptoms==
==History and Symptoms==
Symptoms and signs of Acoustic neuroma considerably dependent on the size of tumor for instance, generalized headacheoccures in less than 20% of patients with small acoustic tumors (less than 2cm), although it can occur in 43 to 75% of patients with tumor over 4cm in diameter.<ref>{{Cite journal|last=Robert G. Hart, M.D. and John Davenport, M.D|first=|date=1981|title=Diagnosis of Acoustic Neuroma|url=|journal=Neurosurgery|volume=4|pages=450|via=}}</ref> In the table 1 you can see major symptoms and signs of acoustic neuroma due to its frequency among patients.<ref>{{Cite journal|last=XIANG HUANG, JIAN XU, MING XU, LIANG-FU ZHOU, RONG ZHANG, LIQIN LANG, QIWU XU, PING ZHONG, MINGYU CHEN, YING WANG and ZHENYU ZHANG|first=|date=2012|title=Clinical features of intracranial vestibular schwannomas|url=|journal=ONCOLOGY LETTERS|volume=|pages=|via=}}</ref>
=== History ===
* Chronic gradual unilateral [[hearing impairment]] is the most common complaint present in 95% of the [[Patient|patients]].
* The [[hearing impairment]] usually occurs in [[Patient|patients]] with longstanding [[disease]] but acoustic neuroma may also present with sudden [[sensorineural hearing loss]].
* Ringing in the [[ear]] [[Tinnitus|(tinnitus)]] is an associated complaint among [[Patient|patients]] with the involvement of [[cochlear nerve]].<ref>{{Cite journal
| author = [[Eric E. Smouha]], [[Michael Yoo]], [[Kristi Mohr]] & [[Raphael P. Davis]]
| title = Conservative management of acoustic neuroma: a meta-analysis and proposed treatment algorithm
| journal = [[The Laryngoscope]]
| volume = 115
| issue = 3
| pages = 450–454
| year = 2005
| month = March
| doi = 10.1097/01.mlg.0000175681.52517.cf
| pmid = 15744156
}}</ref>
* Approximately 50% of [[Patient|patients]] with acoustic neuroma report [[disequilibrium]] and [[sense]] of unsteadiness while [[walking]]. 


{| Style="border: 3px; font-size 60%; margin: 1px; width: 400px;"
=== Common Symptoms ===
! style="background: #191970; " | {{ fontcolor|#FFF|Symptoms and signs in Order of frequency (Table 1}}
* Chronic gradual unilateral [[Hearing impairment|hearing loss]]<ref name=":0">{{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><ref name="HartDavenport1981">{{cite journal|last1=Hart|first1=Robert G.|last2=Davenport|first2=John|title=Diagnosis of Acoustic Neuroma|journal=Neurosurgery|volume=9|issue=4|year=1981|pages=450–463|issn=0148-396X|doi=10.1227/00006123-198110000-00021}}</ref><ref name=":1">{{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 name=":2">{{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 name=":3">{{Cite journal
| author = [[L. R. Lustig]], [[S. Rifkin]], [[R. K. Jackler]] & [[L. H. Pitts]]
| title = Acoustic neuromas presenting with normal or symmetrical hearing: factors associated with diagnosis and outcome
| journal = [[The American journal of otology]]
| volume = 19
| issue = 2
| pages = 212–218
| year = 1998
| month = March
| pmid = 9520059
}}</ref>
* Ringing in the [[ear]]
* [[Disequilibrium]]
* Facial [[Paresthesia|numbness]]
* Facial [[pain]]
* [[Headache]]
 
=== Less Common Symptoms ===
* Facial [[muscle weakness]]<ref name=":0" /><ref name="HartDavenport1981" /><ref name=":1" /><ref name=":2" /><ref name=":3" />
* [[Taste alteration|Taste disturbances]]
* Dryness of the [[Eye|eyes]]
* Sudden [[Tears|lacrimation]]
* Dryness of [[mouth]]
* [[Speech]] problem
* [[Dysphagia|Difficulty swallowing]]
* [[Aspiration (medicine)|Aspiration]]
* [[Dysphonia|Hoarseness]]
* [[Otalgia|Ear pain]]
The below table summarize information about the frequency of major [[Symptom|symptoms]] and [[Medical sign|signs]] of acoustic neuroma:<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><ref name="HartDavenport1981">{{cite journal|last1=Hart|first1=Robert G.|last2=Davenport|first2=John|title=Diagnosis of Acoustic Neuroma|journal=Neurosurgery|volume=9|issue=4|year=1981|pages=450–463|issn=0148-396X|doi=10.1227/00006123-198110000-00021}}</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 = [[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 = [[L. R. Lustig]], [[S. Rifkin]], [[R. K. Jackler]] & [[L. H. Pitts]]
| title = Acoustic neuromas presenting with normal or symmetrical hearing: factors associated with diagnosis and outcome
| journal = [[The American journal of otology]]
| volume = 19
| issue = 2
| pages = 212–218
| year = 1998
| month = March
| pmid = 9520059
}}</ref>
 
{| style="border: 3px; font-size 60%; margin: 1px; width: 700px;"
! colspan="4" style="background: #191970; " |
|-
! colspan="2" style="background: #191970; " | {{fontcolor|#FFF|Major signs and symptoms}}
! colspan="2" style="background: #191970; width: 250px;" | {{fontcolor|#FFF|Diagnostic accuracy of clinical features in predicting the tumor progress}}
|-
! style="background: #191970; " | {{fontcolor|#FFF|Signs and symptoms}}
! style="background: #191970; " | {{fontcolor|#FFF|Frequency}}
! style="background: #191970; " | {{fontcolor|#FFF|Sensitivity}}
! style="background: #191970; " | {{fontcolor|#FFF|Specificity}}
|-
|-
! style="padding: 2px 2px; background: #87cefa; " | Hypacusis
! style="padding: 4px 4px; background: #dcdcdc; " | Hypoacusis ([[hearing impairment]])
! style="padding: 4px 4px; background: #6495ED; " | The most common
! style="padding: 4px 4px; background: #6495ED; " | High
! style="padding: 4px 4px; background: #ADD8E6; " | low
|-
|-
! style="padding: 2px 2px; background: #87cefa; " | Facial paresthesia
! style="padding: 4px 4px; background: #dcdcdc; " | Facial paresthesia
! rowspan="3" style="padding: 4px 4px; background: #6495ED; " | Commonly seen
! rowspan="3" style="padding: 4px 4px; background: #6495ED; " | Moderate
! rowspan="3" style="padding: 4px 4px; background: #87ceeb; " | Moderate
|-
|-
! style="padding: 2px 2px; background: #87cefa; " | Instability of gait
! style="padding: 4px 4px; background: #dcdcdc; " | [[Gait abnormality|Instability of gait]]
|-
|-
! style="padding: 2px 2px; background: #87cefa; " | Tinnitus
! style="padding: 4px 4px; background: #dcdcdc; " | [[Tinnitus]]
|-
|-
! style="padding: 2px 2px; background: #87ceeb; " | Hearing loss
! style="padding: 4px 4px; background: #dcdcdc; " | [[Hearing impairment|Hearing loss]] (deafness)
! rowspan="5" style="padding: 4px 4px; background: #87ceeb; " | Occasionally seen
! rowspan="5" style="padding: 5px 4px; background: #87ceeb; " | low
! rowspan="5" style="padding: 4px 4px; background: #6495ED; " | high
|-
|-
! style="padding: 2px 2px; background: #87ceeb; " | Headache
! style="padding: 4px 4px; background: #dcdcdc; " | [[Headache]]
|-
|-
! style="padding: 2px 2px; background: #87ceeb; " | Facial paralysis
! style="padding: 4px 4px; background: #dcdcdc; " | [[Facial nerve paralysis|Facial paralysis]]
|-
|-
! style="padding: 2px 2px; background: #87ceeb; " | Vertigo
! style="padding: 4px 4px; background: #dcdcdc; " | [[Vertigo]]
|-
|-
! style="padding: 2px 2px; background: #ADD8E6; " | Absent corneal reflex
! style="padding: 4px 4px; background: #dcdcdc; " | Absent corneal reflex
|-
|-
! style="padding: 2px 2px; background: #ADD8E6; " | Bucking
! style="padding: 4px 4px; background: #dcdcdc; " | Bucking
! rowspan="10" style="padding: 4px 4px; background: #ADD8E6; " | Rarely seen
! rowspan="10" style="padding: 4px 4px; background: #ADD8E6; " | Very low
! rowspan="10" style="padding: 4px 4px; background: #6495ED; " | Very high
|-
|-
! style="padding: 2px 2px; background: #ADD8E6; " | Visual disorder
! style="padding: 4px 4px; background: #dcdcdc; " | Visual disorder
|-
|-
! style="padding: 2px 2px; background: #ADD8E6; " | Nausea and vomiting
! style="padding: 4px 4px; background: #dcdcdc; " | [[Nausea and vomiting]]
|-
|-
! style="padding: 2px 2px; background: #B0E0E6; " | Nystagmus
! style="padding: 4px 4px; background: #dcdcdc; " | [[Nystagmus]]
|-
|-
! style="padding: 2px 2px; background: #B0E0E6; " | Movement disorder
! style="padding: 4px 4px; background: #dcdcdc; " | [[Movement disorder]]
|-
|-
! style="padding: 2px 2px; background: #B0E0E6; " | Mastication disorder
! style="padding: 4px 4px; background: #dcdcdc; " | Mastication disorder
|-
|-
! style="padding: 2px 2px; background: #B0E0E6; " | Romberg sign
! style="padding: 4px 4px; background: #dcdcdc; " | [[Romberg's test|Romberg sign]]
|-
|-
! style="padding: 2px 2px; background: #B0E0E6; " | Hoarseness
! style="padding: 4px 4px; background: #dcdcdc; " | [[Dysphonia|Hoarseness]]
|-
|-
! style="padding: 2px 2px; background: #B0E0E6; " | Abduction disorder
! style="padding: 4px 4px; background: #dcdcdc; " | [[Cranial nerves|Abduction disorder]]
|-
|-
! style="padding: 2px 2px; background: #B0E0E6; " | Ear pain
! style="padding: 4px 4px; background: #dcdcdc; " | [[Otalgia|Ear pain]]
|}
|}
Symptoms of acoustic neuroma include:<ref name="wiki">Vestibular Schwannoma. Wikipedia(2015) https://en.wikipedia.org/wiki/Vestibular_schwannoma Accessed on October 2 2015</ref><ref>{{Cite web|url=https ://medlineplus.gov/acousticneuroma.html|title=MedlinePlus Acoustic neuroma|last=|first=|date=|website=|archive-url=|archive-date=|dead-url=|access-date=}}</ref>
*[[Sensorineural]] [[hearing]] loss - often occur gradually and most of times unilateral
*[[Vertigo]]
*[[Tinnitus]]
*[[Facial weakness]]
*Facial [[numbness]] and [[tingling]]
*[[Headaches]]
*[[Dizziness]]
*Difficulty swallowing and [[hoarseness]]
*Taste changes
*[[Confusion]]


==References==
==References==

Latest revision as of 15:46, 26 April 2019

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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

Common Symptoms

Less Common Symptoms

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

  1. ↑ 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. ↑ 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. ↑ 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. ↑ 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. ↑ 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. ↑ 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)
  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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