Acoustic neuroma history and symptoms: Difference between revisions
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{{Acoustic neuroma}} | {{Acoustic neuroma}} | ||
{{CMG}}{{AE}}{{ | {{CMG}}{{AE}}{{M.B}} | ||
==Overview== | ==Overview== | ||
Symptoms of acoustic neuroma may vary depending on the cranial nerve involvement, cerebellar compression, mass size and tumor progression. [[hearing loss]] and [[tinnitus]] almost always are seen in [[cochlear nerve]] involvement, while [[Disequilibrium|unsteadiness]] is common among patients with involvement of the [[vestibular nerve]]. Trigeminal nerve involvement occurs among one-sixth of patients and usually presents with facial paresthesia or hypesthesia. Facial paresis, [[Taste alteration|taste disturbances]], [[xerophthalmia]], paroxysmal [[Tears|lacrimation]], and [[xerostomia]] are less common symptoms which may present due to involvement of the [[facial nerve]]. | Symptoms of acoustic neuroma may vary depending on the cranial nerve involvement, cerebellar compression, mass size and tumor progression. [[hearing loss]] and [[tinnitus]] almost always are seen in [[cochlear nerve]] involvement, while [[Disequilibrium|unsteadiness]] is common among patients with involvement of the [[vestibular nerve]]. [[Trigeminal nerve]] involvement occurs among one-sixth of patients and usually presents with facial [[paresthesia]] or [[hypesthesia]]. Facial [[paresis]], [[Taste alteration|taste disturbances]], [[xerophthalmia]], paroxysmal [[Tears|lacrimation]], and [[xerostomia]] are less common symptoms which may present due to involvement of the [[facial nerve]]. | ||
==History and Symptoms== | ==History and Symptoms== | ||
Symptoms of acoustic neuroma may vary depending on the cranial nerve involvement, cerebellar compression, mass size and tumor progression. [[hearing loss]] and [[tinnitus]] almost always are seen in [[cochlear nerve]] involvement, while [[Disequilibrium|unsteadiness]] is common among patients with involvement of the [[vestibular nerve]]. Trigeminal nerve involvement occurs among one-sixth of patients and usually presents with facial paresthesia or hypesthesia. Facial paresis, [[Taste alteration|taste disturbances]], [[xerophthalmia]], paroxysmal [[Tears|lacrimation]], and [[xerostomia]] are less common symptoms which may present due to involvement of the [[facial nerve]] | Symptoms of acoustic neuroma may vary depending on the cranial nerve involvement, cerebellar compression, mass size and tumor progression. [[hearing loss]] and [[tinnitus]] almost always are seen in [[cochlear nerve]] involvement, while [[Disequilibrium|unsteadiness]] is common among patients with involvement of the [[vestibular nerve]]. Trigeminal nerve involvement occurs among one-sixth of patients and usually presents with facial [[paresthesia]] or [[hypesthesia]]. Facial [[paresis]], [[Taste alteration|taste disturbances]], [[xerophthalmia]], paroxysmal [[Tears|lacrimation]], and [[xerostomia]] are less common symptoms which may present due to involvement of the [[facial nerve]].<ref>{{Cite journal | ||
| author = [[C. Matthies]] & [[M. Samii]] | | author = [[C. Matthies]] & [[M. Samii]] | ||
| title = Management of 1000 vestibular schwannomas (acoustic neuromas): clinical presentation | | title = Management of 1000 vestibular schwannomas (acoustic neuromas): clinical presentation | ||
| Line 30: | Line 30: | ||
=== History === | === History === | ||
* Chronic gradual unilateral hearing impairment is the most common symptom presents in 95 percent of patients. Tinnitus is associated symptom among patients with the involvement of cochlear nerve.<ref>{{Cite journal | * Chronic gradual unilateral [[hearing impairment]] is the most common symptom presents in 95 percent of patients. Average [[symptom]] duration is about four years. The hearing impairment usually presents in chronic, however infrequently acoustic neuroma may present with sudden [[sensorineural hearing loss]]. [[Tinnitus]] is associated symptom among patients with the involvement of [[cochlear nerve]].<ref>{{Cite journal | ||
| author = [[Eric E. Smouha]], [[Michael Yoo]], [[Kristi Mohr]] & [[Raphael P. Davis]] | | author = [[Eric E. Smouha]], [[Michael Yoo]], [[Kristi Mohr]] & [[Raphael P. Davis]] | ||
| title = Conservative management of acoustic neuroma: a meta-analysis and proposed treatment algorithm | | title = Conservative management of acoustic neuroma: a meta-analysis and proposed treatment algorithm | ||
| Line 42: | Line 42: | ||
| pmid = 15744156 | | pmid = 15744156 | ||
}}</ref> | }}</ref> | ||
* | * Approximately 50% of patients with acoustic neuroma report [[disequilibrium]] and sense of unsteadiness while walking. True spinning [[vertigo]] is not common presenting symptoms among patients with acoustic neuroma. | ||
=== Common Symptoms === | === Common Symptoms === | ||
* Chronic gradual unilateral hearing loss | * Chronic gradual unilateral [[Hearing impairment|hearing loss]] | ||
* Tinnitus | * [[Tinnitus]] | ||
* Disequilibrium | * [[Disequilibrium]] | ||
* Facial numbness | * Facial [[Paresthesia|numbness]] | ||
* Facial hypesthesia | * Facial [[hypesthesia]] | ||
* Facial pain | * Facial [[pain]] | ||
* [[Headache]] | |||
=== Less Common Symptoms === | === Less Common Symptoms === | ||
* Facial paresis | * Facial [[paresis]] | ||
* | * [[Taste alteration|Taste disturbances]] | ||
* Xerophthalmia | * [[Xerophthalmia]] | ||
* Paroxysmal lacrimation | * Paroxysmal [[Tears|lacrimation]] | ||
* Xerostomia | * [[Xerostomia]] | ||
* Ataxia | * [[Ataxia]] | ||
* Dysarthria | * [[Dysarthria]] | ||
* Dysphagia | * [[Dysphagia]] | ||
* Aspiration | * [[Aspiration (medicine)|Aspiration]] | ||
* Hoarseness | * [[Dysphonia|Hoarseness]] | ||
* [[Otalgia|Ear pain]] | |||
The below table summarize information about the frequency of major symptoms and signs of acoustic neuroma: | The below table summarize information about the frequency of major symptoms and signs of acoustic neuroma: | ||
Revision as of 16:56, 8 January 2019
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Mohsen Basiri M.D.
Overview
Symptoms of acoustic neuroma may vary depending on the cranial nerve involvement, cerebellar compression, mass size and tumor progression. hearing loss and tinnitus almost always are seen in cochlear nerve involvement, while unsteadiness is common among patients with involvement of the vestibular nerve. Trigeminal nerve involvement occurs among one-sixth of patients and usually presents with facial paresthesia or hypesthesia. Facial paresis, taste disturbances, xerophthalmia, paroxysmal lacrimation, and xerostomia are less common symptoms which may present due to involvement of the facial nerve.
History and Symptoms
Symptoms of acoustic neuroma may vary depending on the cranial nerve involvement, cerebellar compression, mass size and tumor progression. hearing loss and tinnitus almost always are seen in cochlear nerve involvement, while unsteadiness is common among patients with involvement of the vestibular nerve. Trigeminal nerve involvement occurs among one-sixth of patients and usually presents with facial paresthesia or hypesthesia. Facial paresis, taste disturbances, xerophthalmia, paroxysmal lacrimation, and xerostomia are less common symptoms which may present due to involvement of the facial nerve.[1][2][3]
History
- Chronic gradual unilateral hearing impairment is the most common symptom presents in 95 percent of patients. Average symptom duration is about four years. The hearing impairment usually presents in chronic, however infrequently acoustic neuroma may present with sudden sensorineural hearing loss. Tinnitus is associated symptom among patients with the involvement of cochlear nerve.[4]
- Approximately 50% of patients with acoustic neuroma report disequilibrium and sense of unsteadiness while walking. True spinning vertigo is not common presenting symptoms among patients with acoustic neuroma.
Common Symptoms
- Chronic gradual unilateral hearing loss
- Tinnitus
- Disequilibrium
- Facial numbness
- Facial hypesthesia
- Facial pain
- Headache
Less Common Symptoms
- Facial paresis
- Taste disturbances
- Xerophthalmia
- Paroxysmal lacrimation
- Xerostomia
- Ataxia
- Dysarthria
- Dysphagia
- Aspiration
- Hoarseness
- Ear pain
The below table summarize information about the frequency of major symptoms and signs of acoustic neuroma:
| Major signs and symptoms | Diagnostic accuracy of clinical features in predicting the tumor progress | ||
|---|---|---|---|
| Signs and symptoms | Frequency | Sensitivity | Specificity |
| Hypacusis (hearing impairment) | The most common | High | low |
| Facial paresthesia | Commonly seen | Moderate | Moderate |
| Instability of gait | |||
| Tinnitus | |||
| Hearing loss(deafness) | Occasionally seen | low | high |
| Headache | |||
| Facial paralysis | |||
| Vertigo | |||
| Absent corneal reflex | |||
| Bucking | Rarely seen | Very low | Very high |
| Visual disorder | |||
| Nausea and vomiting | |||
| Nystagmus | |||
| Movement disorder | |||
| Mastication disorder | |||
| Romberg sign | |||
| Hoarseness | |||
| Abduction disorder | |||
| Ear pain | |||
References
- ↑ C. Matthies & M. Samii (1997). "Management of 1000 vestibular schwannomas (acoustic neuromas): clinical presentation". Neurosurgery. 40 (1): 1–9. PMID 8971818. Unknown parameter
|month=ignored (help) - ↑ Hart, Robert G.; Davenport, John (1981). "Diagnosis of Acoustic Neuroma". Neurosurgery. 9 (4): 450–463. doi:10.1227/00006123-198110000-00021. ISSN 0148-396X.
- ↑ Xiang Huang, Jian Xu, Ming Xu, Liang-Fu Zhou, Rong Zhang, Liqin Lang, Qiwu Xu, Ping Zhong, Mingyu Chen, Ying Wang & Zhenyu Zhang (2013). "Clinical features of intracranial vestibular schwannomas". Oncology letters. 5 (1): 57–62. doi:10.3892/ol.2012.1011. PMID 23255894. Unknown parameter
|month=ignored (help) - ↑ Eric E. Smouha, Michael Yoo, Kristi Mohr & Raphael P. Davis (2005). "Conservative management of acoustic neuroma: a meta-analysis and proposed treatment algorithm". The Laryngoscope. 115 (3): 450–454. doi:10.1097/01.mlg.0000175681.52517.cf. PMID 15744156. Unknown parameter
|month=ignored (help)