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 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 [[Disequilibrium|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 alteration|taste disturbances]], [[xerophthalmia]], paroxysmal [[Tears|lacrimation]], and [[xerostomia]] are less common symptoms which may present due to involvement of the [[facial nerve]].
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]].


==History and Symptoms==
==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 [[Disequilibrium|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 alteration|taste disturbances]], [[xerophthalmia]], paroxysmal [[Tears|lacrimation]], and [[xerostomia]] are less common symptoms which may present due to involvement of the [[facial nerve]]..<ref>{{Cite journal
=== 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]].
 
=== Common Symptoms ===
* Chronic gradual unilateral [[Hearing impairment|hearing loss]]<ref name=":0">{{Cite journal
  | author = [[C. Matthies]] & [[M. Samii]]
  | author = [[C. Matthies]] & [[M. Samii]]
  | title = Management of 1000 vestibular schwannomas (acoustic neuromas): clinical presentation
  | title = Management of 1000 vestibular schwannomas (acoustic neuromas): clinical presentation
Line 16: Line 34:
  | month = January
  | month = January
  | pmid = 8971818
  | 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
}}</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]]
  | 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
  | title = Clinical features of intracranial vestibular schwannomas
Line 27: Line 45:
  | doi = 10.3892/ol.2012.1011
  | doi = 10.3892/ol.2012.1011
  | pmid = 23255894
  | pmid = 23255894
}}</ref>  
}}</ref><ref name=":2">{{Cite journal
 
| author = [[Robert W. Foley]], [[Shahram Shirazi]], [[Robert M. Maweni]], [[Kay Walsh]], [[Rory McConn Walsh]], [[Mohsen Javadpour]] & [[Daniel Rawluk]]
=== History ===
| title = Signs and Symptoms of Acoustic Neuroma at Initial Presentation: An Exploratory Analysis
* Chronic gradual unilateral hearing loss is the most common symptom presents in 95 percent of patients. Tinnitus is associated symptom among patients with the involvement of cochlear nerve.
| journal = [[Cureus]]
* True spinning vertigo is very uncommon presenting symptoms among patients with acoustic neuroma. Approximately 50% of patients with acoustic neuroma report disequilibrium and sense of unsteadiness while walking.
| volume = 9
 
| issue = 11
=== Common Symptoms ===
| pages = e1846
* Chronic gradual unilateral hearing loss
| year = 2017
* Tinnitus
| month = November
* Disequilibrium
| doi = 10.7759/cureus.1846
* Facial numbness
| pmid = 29348989
* Facial hypesthesia
}}</ref><ref name=":3">{{Cite journal
* Facial pain
| 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 ===
=== Less Common Symptoms ===
* Facial paresis
* Facial [[muscle weakness]]<ref name=":0" /><ref name="HartDavenport1981" /><ref name=":1" /><ref name=":2" /><ref name=":3" />
* taste disturbances
* [[Taste alteration|Taste disturbances]]
* Xerophthalmia,
* Dryness of the [[Eye|eyes]]
* Paroxysmal lacrimation
* Sudden [[Tears|lacrimation]]
* Xerostomia
* Dryness of [[mouth]]
* Ataxia
* [[Speech]] problem
* Dysarthria
* [[Dysphagia|Difficulty swallowing]]
* Dysphagia
* [[Aspiration (medicine)|Aspiration]]
* Aspiration
* [[Dysphonia|Hoarseness]]
* Hoarseness
* [[Otalgia|Ear pain]]
The below table summarize information about the frequency of major symptoms and signs of acoustic neuroma:
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;"
{| style="border: 3px; font-size 60%; margin: 1px; width: 700px;"
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! style="background: #191970; " | {{fontcolor|#FFF|Specificity}}
! style="background: #191970; " | {{fontcolor|#FFF|Specificity}}
|-
|-
! style="padding: 4px 4px; background: #dcdcdc; " | Hypacusis ([[hearing impairment]])
! style="padding: 4px 4px; background: #dcdcdc; " | Hypoacusis ([[hearing impairment]])
! style="padding: 4px 4px; background: #6495ED; " | The most common
! style="padding: 4px 4px; background: #6495ED; " | The most common
! style="padding: 4px 4px; background: #6495ED; " | High
! style="padding: 4px 4px; background: #6495ED; " | High
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! style="padding: 4px 4px; background: #dcdcdc; " | [[Tinnitus]]
! style="padding: 4px 4px; background: #dcdcdc; " | [[Tinnitus]]
|-
|-
! style="padding: 4px 4px; background: #dcdcdc; " | [[Hearing impairment|Hearing loss]](deafness)
! 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: 4px 4px; background: #87ceeb; " | Occasionally seen
! rowspan="5" style="padding: 5px 4px; background: #87ceeb; " | low
! rowspan="5" style="padding: 5px 4px; background: #87ceeb; " | low

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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