Acoustic Neuroma

Unheard

Step 1: View clinicals

A 55 year old man presents with impaired hearing and tinnitus of his right ear for 3 years. There was no history of trauma, headache, convulsions, episodes of vomiting, or prolonged exposure to loud noise. His medical history is unremarkable and he is not on any medications.


Step 2: Order all relevant investigations

Audiometry

There is a R/s sensorineural hearing loss affecting high frequencies.

Lumbar Puncture

All indices in the cerebrospinal fluid (CSF) analysis report are within normal parameters.

MRI Brain

There is a 1.7cm x 2.2cm mass at the right cerebellopontine angle, entering the internal auditory meatus; the imaging characteristics are suggestive of an acoustic neuroma.

X-Ray Skull

Anteroposterior and lateral x-rays of the skull appear normal.


Step 3: Select appropriate management

Surgical Resection
Chemotherapy
Corneal Protection
Nerve Grafting


Score: ★★☆