Delayed diagnosis of large cerebello-pontine angle tumors, despite hearing conservation training

Author(s): Hargraves, R. W., Cook, L. E.

Journal/Book: Milit Med. 1996; 161: 9320 Old Georgetown Rd, Bethesda, MD 20814. Assn Military Surg US. 108-112.

Abstract: Recently, at the National Naval Medical Center in Bethesda, Maryland, we have encountered several patients with large cerebello-pontine angle tumors. All mere active duty and had evaded the military's stringent hearing screening program until the tumors were of life-threatening size. Early detection of these tumors can reduce overall morbidity and improve the patient's chances of returning to a normal lifestyle. We have analyzed each of these cases and discovered weaknesses in the program, The primary difficulty was in accurately following the algorithms set forth by military regulations. To that end me recommend: (1) establishing a cutoff for identification of those who should be evaluated after they obtain their enlistment/annual physical examinations; (2) specific training for hearing conservation program managers in the algorithms for hearing screening; (3) establishment of specific guidelines for primary we physicians for further evaluation of abnormal audiograms; and (4) reevaluation of form DD 2216.

Note: Article RB Mason, Natl Naval Med Res Inst, Dept Neurosurg, Bethesda, MD 20889 USA

Keyword(s): SMALL ACOUSTIC NEUROMAS

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