ENT - acoustic neuroma Flashcards

1
Q

What is an acoustic neuroma?

A

Benign tumour of the Scwann cells surrounding the vestibulocochlear nerve that innervates the inner ear

Aka vestibular schwanomas

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2
Q

Where do they occur?

A

At the cerebellopontine angle

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3
Q

Unilateral vs bilateral

A

Acoustic neuromas - are usually unilateral

Bilateral acoustic neuromas - almost certainly means NF type 2

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4
Q

Typical presentation of acoustic neuroma

A

Usually 40-60 years old with gradual onset of:

  • Unilateral sensorineural hearing loss (often the 1st Sx)
  • Unilateral tinnitus
  • Dizziness or imbalance
  • A sensation of fullness within the ear

Can also be associated with a facial nerve palsy if the tumour grows large enough to compress the facial nerve

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5
Q

Investigations in suspected acoustic neuroma

A

Audiometry - will show sensorineural pattern of hearing loss

Rinne’s and Weber’s test

MRI or CT brain (MRI provides more detail than CT)

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6
Q

Management of acoustic neuroma

A

Conservative management with monitoring may be used if there are no symptoms or treatment is inappropriate

Surgery to remove the tumour (partial or total removal)

Radiotherapy to reduce the growth

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7
Q

Risks associated with treatment

A

Vestibulocochlear nerve injury - with permanent hearing loss or dizziness

Facial nerve palsy - facial weakness

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