Neoplasia Of EAR

Question 1

What is acoustic neuroma?

Answer 1

Acoustic neuroma is a neurofibroma which arises from the sheath of Schwann (neurilemma) of the 8th cranial nerve
It is a slow growing & non invasive benign tumor
Firm nodular yellowish tumor
Usually arises at the point of emergence of the nerve from the internal audiotory meatus

Question 2

Symptoms of acoustic neuroma in chronological order?

Answer 2

(1) Acoustic symptoms ~> deafness(sensorineural), tinnitus & less commonly vertigo
(2) Trigeminal symptoms ~> pain, tingling & numbness in amy lart supplied by trigeminal nerve, Diminished corneal sensation and reflexes occur
(3)Headache ~> dull in character
(4) cerebellar symptoms
(5) Diplopia due to raised intracranial pressure
(6)facial paralysis
(7) terminal symptoms ~> blindness from papilloedema, delirium & coma

Question 3

Differential diagnosis of acoustic neuroma?

Answer 3

This condition is to be differentiated from
Meningioma
Neuroma of 7th nerve
Congenital cholesteatoma
Aneurysm of the basilar or vertebral artery

Question 4

Investigations of acoustic neuroma

Answer 4

Radiography
~plain radiograph of internal auditory canal
~ CT scan
~ MRI

Brainstem evoked response audiometry (BERA)