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Nursing Times
Topics: Humans; Neuroma, Acoustic; Patient Care Planning
PubMed: 2928159
DOI: No ID Found -
The Journal of International Advanced... Jan 2023Few investigations have been conducted on the clinical characteristics of the differential diagnosis of acoustic neuroma with acute sensorineural hearing loss and...
BACKGROUND
Few investigations have been conducted on the clinical characteristics of the differential diagnosis of acoustic neuroma with acute sensorineural hearing loss and idiopathic sudden sensorineural hearing loss. The aim of the study was to investigate the clinical characteristics of the differential diagnoses between acoustic neuroma and idiopathic sudden sensorineural hearing loss.
METHODS
The medical records of patients with acute sensorineural hearing loss (142 ears), including acoustic neuroma (19 ears) and idiopathic sudden sensorineural hearing loss (123 ears), who underwent audiometric and hematologic examinations and received systemic corticosteroid treatment, were retrospectively reviewed.
RESULTS
Hematological examination revealed that the erythrocyte sedimentation rate and fibrinogen values were significantly higher in the idiopathic sudden sensorineural hearing loss group compared to the acoustic neuroma group. Although all patients received corticosteroid treatment, hearing thresholds at the initial examination and 3 months after corticosteroid treatment were significantly higher in the idiopathic sudden sensorineural hearing loss group compared to the acoustic neuroma group at all frequencies. However, hearing recovery was worse in the acoustic neuroma group compared to the idiopathic sudden sensorineural hearing loss group. Furthermore, speech discrimination and short increment sensitivity index tests were not significantly different between the acoustic neuroma and idiopathic sudden sensorineural hearing loss groups.
CONCLUSION
This is the first study to reveal that speech discrimination and short increment sensitivity index tests are not useful for the differential diagnoses between acoustic neuroma and idiopathic sudden sensorineural hearing loss, whereas erythrocyte sedimentation rate and fibrinogen, blood biomarkers of inflammation and blood viscosity, would be considered valuable. Furthermore, acoustic neuroma should be considered in cases where acute sensorineural hearing loss did not recover after corticosteroid treatment, although the initial hearing loss was mild.
Topics: Humans; Neuroma, Acoustic; Retrospective Studies; Hearing Loss, Sensorineural; Hearing Loss, Sudden; Adrenal Cortex Hormones; Fibrinogen
PubMed: 36718029
DOI: 10.5152/iao.2023.22720 -
Progress in Neurological Surgery 2008Management options for patients with vestibular schwannomas (acoustic neuromas) include observation, resection, stereotactic radiosurgery, or fractionated radiotherapy.... (Review)
Review
Management options for patients with vestibular schwannomas (acoustic neuromas) include observation, resection, stereotactic radiosurgery, or fractionated radiotherapy. In this report, we review our experience with radiosurgery over a 20-year interval, and discuss indications and expectations with the different approaches. There has been an evolution in available technologies, and an evolution in both patient and physician approaches to the management of this tumor. Patient decisions must be based on quality information from the peer-reviewed literature. Future concepts for radiosurgery are discussed.
Topics: Dose Fractionation, Radiation; Humans; Neuroma, Acoustic; Radiosurgery
PubMed: 18810226
DOI: 10.1159/000157173 -
Health Technology Assessment... Mar 2009To evaluate the clinical effectiveness and cost-effectiveness of a range of diagnostic strategies for investigating patients with unilateral hearing loss and/or... (Review)
Review
OBJECTIVE(S)
To evaluate the clinical effectiveness and cost-effectiveness of a range of diagnostic strategies for investigating patients with unilateral hearing loss and/or tinnitus, with a view to confirming or eliminating a diagnosis of acoustic neuroma, and to describe the natural history of acoustic neuroma.
DATA SOURCES
Major electronic databases were searched from January 1980 to August 2008.
REVIEW METHODS
Selected studies were assessed and subjected to data extraction and quality assessment using standard methods.
RESULTS
Studies comparing auditory brainstem response (ABR) with magnetic resonance (MR) imaging were highly heterogeneous. ABR has high sensitivity compared with MR imaging for acoustic neuromas greater than 1 cm in size but not for smaller neuromas. The sensitivities of T2-weighted (T2W) and T2-star-weighted (T2*W) imaging strategies compared with gadolinium-enhanced T1-weighted (GdT1W) MR imaging (gold standard) were high and relatively homogeneous. The specificity of T2W and T2*W studies ranged from 90% to 100% and from 86% to 99% respectively. The review of cost-effectiveness showed that GdT1W MR imaging immediately or in conjunction with ABR appears to be more cost-effective than 'traditional' protocols; ABR/GdT1W MR imaging protocols were more cost-effective than going directly to GdT1W MR imaging. Non-contrast-enhanced MR imaging was found to be a more cost-effective test for acoustic neuroma than GdT1W MR imaging. The incidence of acoustic neuroma has increased over the last 30 years, with the median age at diagnosis remaining at 55 years. Most patients present with insidious symptoms of unilateral hearing impairment, tinnitus and/or vertigo. The pattern and rate of growth of acoustic neuroma are highly variable and currently unpredictable. At least 50% of tumours do not grow, at least for some years after diagnosis. Some studies have found large initial size to be a determinant of later growth, with the opposite also being reported. The mean growth rate for all tumours varies between 1 and 2 mm/year, with a rate of 2-4 mm/year for only those that grow; however, there are cases with significant regression (5%) or exceptional growth (which may exceed 18 mm/year).
CONCLUSIONS
The majority of the evidence reviewed was poorly reported and there is therefore an inherent risk of bias. Given the recent improvement in resolution and reduction in cost of MR imaging, ABR can no longer be considered appropriate as the primary test used to screen for acoustic neuroma. T2W or T2*W sequences enable accurate evaluation of the VIIIth and VIIth cranial nerves within the cerebellopontine angle and internal auditory canal as well as evaluation of the cochlea and labyrinth, and inclusion of GdT1W sequences is unlikely to contribute information that would alter patient management in the screening population. The quality of the imaging chain and experience of the reporting radiologist are key factors determining the efficacy of a non-contrast screening strategy. Based on a cost-effectiveness model developed to reflect UK practice it was concluded that a diagnostic algorithm that deploys non-contrast MR imaging as an initial imaging screen in the investigation of acoustic neuroma is less costly than and likely to be as effective as available contrast MR imaging.
Topics: Age Distribution; Cost-Benefit Analysis; Evoked Potentials, Auditory, Brain Stem; Hearing Tests; Humans; Incidence; Magnetic Resonance Imaging; Neuroma, Acoustic; Prevalence; Reproducibility of Results; Technology Assessment, Biomedical
PubMed: 19358774
DOI: 10.3310/hta13180 -
The American Journal of Otology Jul 1996
Comparative Study Review
Topics: Ear Neoplasms; Facial Paralysis; Humans; Microsurgery; Neuroma, Acoustic; Postoperative Complications; Terminology as Topic; Vestibule, Labyrinth
PubMed: 8841720
DOI: No ID Found -
Clinical Otolaryngology and Allied... Dec 1994This study assesses the outcome in 78 patients who had been diagnosed with acoustic neuroma over a period of 13 years. Forty-six patients were treated with...
This study assesses the outcome in 78 patients who had been diagnosed with acoustic neuroma over a period of 13 years. Forty-six patients were treated with translabyrinthine surgery, 13 with suboccipital surgery and/or ventricular drainage, and 19 patients (20 neuromas) were kept under observation. Of the 59 patients who had surgery, four died, 30 had problems with eating, drinking and balance, 17 had severe facial palsy, 21 discontinued their work after the operation and 30 had psychological problems. Twenty neuromas have not been operated upon and the patients have not deteriorated medically or socially. It is concluded that acoustic neuroma is a serious disease and that a conservative policy (wait and scan) is preferable in elderly patients.
Topics: Adult; Aged; Aged, 80 and over; Dizziness; Drinking; Ear, Inner; Eating; Facial Paralysis; Female; Follow-Up Studies; Hearing Disorders; Humans; Male; Middle Aged; Neuroma, Acoustic; Occipital Bone; Postoperative Complications; Postural Balance; Quality of Life; Social Class; Treatment Outcome; Vertigo
PubMed: 7895377
DOI: 10.1111/j.1365-2273.1994.tb01273.x -
The Pan African Medical Journal 2019Neurofibromatosis type 2 (NF2) is a rare autosomal dominant disorder characterized by formation of central nervous system tumors. They are associated to significant...
Neurofibromatosis type 2 (NF2) is a rare autosomal dominant disorder characterized by formation of central nervous system tumors. They are associated to significant morbidity due to multiple problems such as hearing loss that can lead to many psychiatric disorders.
Topics: Hearing Loss; Humans; Male; Mental Disorders; Neurofibromatosis 2; Neuroma, Acoustic; Young Adult
PubMed: 31448042
DOI: 10.11604/pamj.2019.33.80.18398 -
Neurosurgical Focus Sep 2012
Topics: Humans; Neuroma, Acoustic
PubMed: 22937861
DOI: 10.3171/2012.8.FOCUS12277 -
Otolaryngologic Clinics of North America Apr 2012Local support groups are an important part of the support network for acoustic neuroma and neurofibromatosis patients. For many people, the local support group is the... (Review)
Review
Local support groups are an important part of the support network for acoustic neuroma and neurofibromatosis patients. For many people, the local support group is the only place where they can make personal contact with other patients who have gone through a similar experience. This article specifically looks at the Acoustic Neuroma Association and Neurofibromatosis, Incorporated and describes how these organizations help individuals.
Topics: Adaptation, Physiological; Female; Humans; Interpersonal Relations; Male; Neurofibromatosis 2; Neuroma, Acoustic; Patient Satisfaction; Quality of Life; Self-Help Groups; Sickness Impact Profile; Stress, Psychological; Ultrasonography
PubMed: 22483831
DOI: 10.1016/j.otc.2011.12.016 -
Neurosurgery Jun 1992
Review
Topics: Forecasting; Humans; Neuroma, Acoustic; Postoperative Complications
PubMed: 1614607
DOI: No ID Found