Acoustic Neuroma:Correlations Between Nature Of The Tumor And Otological Manifestations

Objective:To describe the effection of hearing and vestibular examination in the diagnosis of acoustic neuroma, and to explore its correlation with tumor cystic or solid.Methods:A total of 57 patients were diagnosed acoustic neuroma in otolaryngology head and neck surgery, neurosurgery department of the second affiliated hospital of Chongqing medical university from January 2004-January 2015. Anlysis of the clinical symptoms of acoustic neuroma, pure-tone audiometry, speech discrimination score (SDS), immittancemetry including tympanometry, and stapes muscle reflex, distortion product otoacoustic emission, auditory brainstem response (ABR). Cystic acoustic neuroma was defined in the MRI or intraoperative confirmed cystic component within tumor. Analyzing the correlation of cystic tumor and tumor size, location, the clinical manifestation, auditory examination.Results:The most common symptoms of acoustic neuroma was hearing loss (80.49%), following tinnitus (52.63%), dizziness (31.58%), cranial nerve injury symptoms (17.54%). pure-tone audiometry is given priority to with decline type (36.84%) and flat type (28.07%) PTA64.24±21.67dB, SDS 36.37±28.04%,74.07% of DPOAE is normal. 80.49% of stapes muscle reflex is positive, ABR abnormal rate was 94.73%. both stapes muscle reflex and ABR has 98.25%. Cystic tumor of tumors had bigger and more located in cerellopontine angle (P= 0.009), Cystic tumor group presents more cranial nerve symptom (P= 0.044)、the PTA decline more serious (P= 0.014),but there was no significant difference of SDS. Cystic and solid tumor of ABR absolute latency of wave of Ⅰ, Ⅲ, Ⅴ, interpeak latency of Ⅰ-Ⅲ,Ⅲ-Ⅴ, Ⅰ-Ⅴ, ILDV, ILD (Ⅰ-Ⅴ), contralateral Ⅲ-Ⅴ/Ⅰ-Ⅲ was no significant difference, tumor cystic degeneration correlated with ILD (Ⅰ-Ⅴ) (P= 0.011), the contralateral Ⅲ-Ⅴ/Ⅰ-Ⅲ(P= 0.025).Conclusion:Patients manifest hearing loss, tinnitus, vertigo, shall be for the PTA,SDS, stapes muscle reflex, DPOAE, ABR joint application are a screening for early diagnosis. Cystic acoustic neuroma manifests the large size tumor, more cranial nerve symptoms, PTA is worse, abnormal ILD (Ⅰ-Ⅴ), the contralateral Ⅲ-Ⅴ/Ⅰ-Ⅲ.