Acoustic neuroma

Question 1

What are the features of acoustic neuroma?

Answer 1

Combination of vertigo, hearing loss, tinnitus and an absent corneal reflex. Features can be predicted by the affected cranial nerves:
cranial nerve VIII: vertigo, unilateral sensorineural hearing loss, unilateral tinnitus
cranial nerve V: absent corneal reflex
cranial nerve VII: facial palsy

Typical findings of Rinne’s and Weber’s test are:

Rinne’s test: air conduction > bone conduction bilaterally
Weber’s test: sound lateralises to the unaffected ear indicating SNHL3

Question 2

What is the management for acoustic neuroma?

Answer 2

should be referred urgently to ENT. It should be noted though that the tumours are often slow growing, benign and often observed initially
Management is with either surgery, radiotherapy or observation..

Question 3

What are the investigations for acoustic neuroma?

Answer 3

MRI of the cerebellopontine angle. Audiometry is also important

Question 4

What are acoustic neuromas?

Answer 4

rare tumours of the vestibulocochlear nerve, arising from the Schwann cells of the nerve sheath (also known as vestibular schwannomas).

Question 5

Where do acoustic neuromas develop?

Answer 5

the internal auditory meatus and at the cerebellopontine angle

Question 6

What is the characteristic of a acoustic neuroma tumour?

Answer 6

Benign slow-growing uni-lateral

Question 7

What are the risk factors of acoustic neuroma?

Answer 7

High-dose ionising radiation to the head and neck
Neurofibromatosis type 2 (NF2)