Acoustic neuroma inv &man
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Transcript of Acoustic neuroma inv &man
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Good Morning…
A Small presentation by.. S.Vigneshwaran 3rd year Medico
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Investigations
&
Management
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Investigations• Attempts should be made to
diagnose tumour in its Otological Phase
Intracanalicular
Unilateral sensorineural Hearing loss
TinnitusImbalance
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Audiological tests Pure tone Audiometry
Sensorineural hearing loss – High Frequencies
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Speech audiometry
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Roll over phenomenonReduction of Discrimination score when loudness increased beyond Particular limit
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Recruitment phenomenonSmall increase in noise level seems to be much louder and cause discomfort..
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SISI
Score 0-20% in 70-90% cases
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Threshold tone decay test
• Shows retrocochlear type of lesions
• Cochlear Fatigue
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Stapedial reflex decay test
Involuntary muscle contractions
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Vestibular tests
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Neurological tests
Examination of..
•Cranial nerves
•Cerebellar functions
•Brainstem signs
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Fundus Examination
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Radiological tests
• Plain X-Rays
Stenver view
Transorbital view
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Computed Tomography
Tumour in Posterior fossa
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Magnetic Resonance Imaging..
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Vertebral AngiographyTo differentiate between Acoustic neuroma & Cerebellopontine angle tumours
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Evoked Response Audiometry
• Retrocochlear lesions• 8th Nerve tumour
0.2 msDelay
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CSF
Raised Protein Level
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Important tests for workup..
• Pure tone audiometry• Speech discrimination score• Roll over curve• Stapedial reflex decay• Evoked response audiometry• MRI with contrast
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Treatment
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Surgery
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Radiotheraphy
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