Unusual presentations of acoustic tumours

Abstract

A series of 238 consecutive patients with acoustic neuromas, operated on in Paris has been studied to identify unusual presentations and varied symptomatology. The most common history was that of a progressive unilateral hearing loss (in 68.1%), with tinnitus (in 49.1%) or disequilibrium (in 49.1%) or both. Sudden hearing loss (in 14.7%) or fluctuating hearing loss (in 6.3%), and a single or repeated episodes of acute vertigo (in 8.8%) were seen less commonly. Headaches occurred as an associated symptom in 10.5%, tinnitus was the sole symptom in 2.8% and other uncommon symptoms included otalgia, facial nerve palsy, facial or ocular pain, altered sensation in the face or eye, or tingling of the tongue. Some 11.3% of patients presented with normal pure tone auditory thresholds and a 100% speech discrimination score and of these patients acoustic reflex thresholds were normal in 53% and brainstem auditory evoked responses were suggestive of the retro-cochlear abnormality in only 76.2%. Amongst the less common presentations, the initial symptoms mimicked such diagnoses as Meniére's disease, benign positional vertigo, vertebro-basilar migraine, vertebro-basilar insufficiency, Bell's palsy and Trigeminal neuralgia. Overall, 20.6% of patients had unusual initial presenting symptoms, 36.5% of the symptoms were unusual and these were found in isolation in 11.8% of patients. An awareness of the spectrum of more subtle symptoms of acoustic tumours may lead to the correct diagnosis at an earlier stage.

Vestibular Schwannoma and Ipsilateral Endolymphatic Hydrops: An Unusual Association

“…The presentation of simultaneous VS and ELH on the same side in the same patient is uncommon and has seldom been described in the literature [13][14][15][16] . Although the two pathologies are most probably of independent origin and should be considered separate entities, presenting and ongoing symptoms may overlap and may cause an incorrect treatment of the cochlear disorder (i.e.…”

“…postponing the execution of a MRI) or a potential misinterpretation of VS evolution (i.e. attributing symptoms to VS growth instead of inner ear dysfunction, or vice-versa) 13,[16][17][18][19] .…”

Current state of early diagnosis of vestibular schwannoma

“…Эти симптомы обус-ловлены сдавлением VIII пары черепных нервов во внутреннем слуховом канале. По мере роста опухоли и сдавления V и VII пар черепных нервов появля-ются оталгия, онемение на лице, слабость (парез) мимических мышц, изменения вкуса [12,13].…”

“…Эти симптомы обус-ловлены сдавлением VIII пары черепных нервов во внутреннем слуховом канале. По мере роста опухоли и сдавления V и VII пар черепных нервов появля-ются оталгия, онемение на лице, слабость (парез) мимических мышц, изменения вкуса [12,13].По данным ретроспективного анализа историй болезни, правильный диагноз при первичном обра-щении пациентов к врачам разных специальностей установлен только у 8,6% из них [14]. По данным Института отоларингологии им.…”

Silent Vestibulopathy in Asymmetric Hearing Loss Can Be a Sign of a Cerebellopontine Angle Tumor

“…CPA tumors are manifested by cranial neuropathies related to their location. Despite that VSs typically originate in the inferior vestibular nerve (62-91%), followed by the superior vestibular nerve (6-38%) [8][9][10], the rate of vertigo reported in patients with a VS is variable, ranging from 19 to 61% [2,4,[11][12][13]. Clinical manifestations of a CPA meningioma do not differ significantly from those of a VS [14], and many patients do not experience vertigo.…”