Normal hearing in acoustic neuroma patients: A critical evaluation

Author(s): Aristegui, M., Naguib, M. B., Cokesser, Y., Landolfi, M., Sanna, M.

Journal/Book: Amer J Otology. 1996; 17: 4 Hughson St, PO Box 620, LCD 1, Hamilton on L8N 3K7, Canada. Decker Periodicals Inc. 127-132.

Abstract: A series of 128 acoustic neuromas (ANs) managed in our center in the last 6 years were evaluated. Sixteen cases (12.5%) were found to have normal pure tone audio-grams comparatively younger age was an important characteristic of these patients. Tinnitus, dysequilibrium, and subjective hearing loss or distortion were their most common complaints. Pure tone audiometry showed a mean pure tone average of 14.5 dB. Speech discrimination score and performance intensity phonetically balanced index were very insensitive and showed very high false-negative results. Auditory brainstem responses proved to be a reliable test, being positive in 93.8% of cases. The mean tumor size did not show any significant difference when compared with acoustic neuroma cases with abnormal hearing. The combination of otologic and neurotologic symptoms in a young patient should prompt the clinician to investigation further even if hearing is within normal limits. A high index of suspicion is a prerequisite for the early diagnosis of such subtle lesions.

Note: Article EA Saleh, Grp Otol, Via Emmanueli 42, I-29100 Piacenza, Italy

Keyword(s): normal hearing; acoustic neuroma; auditory brainstem responses; PURE-TONE HEARING

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