Fortnightly Review: Management of acoustic neuroma

BMJ 1995;311:1141-1144 (28 October)

Education and debate

A Wright, professor of otolaryngology,^a R Bradford, consultant neurosurgeon ^b

^a Royal National Throat, Nose and Ear Hospital, London WC1X 8EE, ^b Royal Free Hospital Medical School, London NW3 2QG

Correspondence to: Professor Wright.

Summary points

The onset of unilateral auditory symptoms requires investigation
A unilateral sensorineural loss or tinnitus when the eardrum is normal also needs further investigation
The definitive investigation is gadolinium enhanced magnetic resonance scanning
Neurological symptoms suggestive of compression of the lower cranial nerves, ataxia, or raised intracranial pressure may be caused by benign tumours in the cerebellopontine angle
Treatments include expectant care with repeat scanning to assess tumour growth in elderly people, and surgery with or without stereotactic radiotherapy
The smaller the tumour the lower the risks of treatment