Acoustic neuroma physical examination: Difference between revisions
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===Ear Examination=== | ===Ear Examination=== | ||
*[[Sensorineural hearing loss]] in the affected ear | *[[Sensorineural hearing loss]] in the affected ear | ||
*Rinne test is positive | |||
*[[Rinne test]] is positive: air conduction > bone conduction (both air and bone conduction are decreased equally, but the difference between them is unchanged). | |||
*Weber [[test]] lateralizes to the normal [[ear]] | *Weber [[test]] lateralizes to the normal [[ear]] | ||
*[[Weber test]]: Sound localizes to normal ear.<ref>{{Cite web | title =Wikipedia sensorineural hearing loss| url =https://en.wikipedia.org/wiki/Sensorineural_hearing_loss }}</ref> | |||
*[[ | |||
===Eye examination=== | ===Eye examination=== | ||
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*Cranial nerve VII- Facial [[twitching]] or hypesthesia may occur. [[Drooling]] may occur. Drooping on one side of the [[face]] may occur. Loss of taste may occur. | *Cranial nerve VII- Facial [[twitching]] or hypesthesia may occur. [[Drooling]] may occur. Drooping on one side of the [[face]] may occur. Loss of taste may occur. | ||
*Cranial nerve VIII- In [[sensorineural]] hearing loss Rinne test is positive and Weber test is abnormal. | *Cranial nerve VIII- In [[sensorineural]] hearing loss Rinne test is positive and Weber test is abnormal. | ||
*Cranial nerve IX- the back half of the [[tongue]] can lose its sense of taste. | *Cranial nerve IX- the back half of the [[tongue]] can lose its sense of taste. | ||
*Cerebellum: The following tests may be positive: | *Cerebellum: The following tests may be positive: | ||
Revision as of 20:24, 1 October 2015
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Acoustic neuroma Microchapters | |
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Diagnosis | |
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Treatment | |
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Case Studies | |
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Acoustic neuroma physical examination On the Web | |
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American Roentgen Ray Society Images of Acoustic neuroma physical examination | |
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Risk calculators and risk factors for Acoustic neuroma physical examination | |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Simrat Sarai, M.D. [2]
Overview
Common physical examination findings of acoustic neuroma include lateralization to the normal ear in Weber test, decreased or absent ipsilateral corneal reflex, facial twitching or hypesthesia, and abnormal caloric stimulation test.[1]
Physical Examination
Diagnosis of acoustic neuromas begins with a history and physical examination, followed by otologic testing, and finally radiologic scanning. MRI scan with gadolinium enhancement is the most common radiological test. On the scan, the size and shape of the tumor can be visualized.
Ear Examination
- Sensorineural hearing loss in the affected ear
- Rinne test is positive
- Rinne test is positive: air conduction > bone conduction (both air and bone conduction are decreased equally, but the difference between them is unchanged).
- Weber test lateralizes to the normal ear
- Weber test: Sound localizes to normal ear.[2]
Eye examination
- Nystagmus may be present
- Papilledema may be present
- Diplopia on lateral gaze may be present
Neurological Examination
Often, the physical exam is normal at the time the tumor is diagnosed. Occasionally, the following cranial nerves may be affected:[3]
- Cranial nerve V- A decreased or absent ipsilateral corneal reflex.
- Cranial nerve VII- Facial twitching or hypesthesia may occur. Drooling may occur. Drooping on one side of the face may occur. Loss of taste may occur.
- Cranial nerve VIII- In sensorineural hearing loss Rinne test is positive and Weber test is abnormal.
- Cranial nerve IX- the back half of the tongue can lose its sense of taste.
- Cerebellum: The following tests may be positive:
- Romberg, Hall-Pike, and other balance tests are typically normal.
- Electronystagmography (ENG testing) is frequently abnormal. Unilateral loss of calorics is associated in about 50% of all tumors.