Prevalence of Acoustic Neuroma Associated with Each Configuration of Pure Tone Audiogram in Patients with Asymmetric Sensorineural Hearing Loss

Suzuki, Masuko; Hashimoto, Sho; Kano, Shigeyuki; Okitsu, Takuji

doi:10.1177/000348941011900908

Cited by 32 publications

(40 citation statements)

References 13 publications

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“…It would be ideal to use a relatively simple, low‐cost test as a first screening tool for VS, such as PTA. Most screening protocols published in this review make use of PTA as a screening tool . Based on the pooled results from this meta‐analysis, AAO‐HNS, Obholzer 1 and Sunderland protocols appeared to have highest sensitivities in detecting VS, but all three have poor specificities .…”

Section: Discussionmentioning

confidence: 92%

See 1 more Smart Citation

The diagnostic accuracy of non‐imaging screening protocols for vestibular schwannoma in patients with asymmetrical hearing loss and/or unilateral audiovestibular dysfunction: a diagnostic review and meta‐analysis

Hentschel¹,

Scholte²,

Steens

et al. 2016

Clinical Otolaryngology

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Section: Discussionmentioning

confidence: 92%

“…Sensitivity of PTA shape as a screening test ranged from 0% [95% CI: 0–25] for low‐frequency and mountain‐shaped loss to 76% [95% CI: 69–82] for sloping loss and specificity from 29% [95% CI: 23–36] to 99% [95% CI: 96–100] for a sloping and peak loss, respectively …”

Section: Resultsmentioning

confidence: 99%

The diagnostic accuracy of non‐imaging screening protocols for vestibular schwannoma in patients with asymmetrical hearing loss and/or unilateral audiovestibular dysfunction: a diagnostic review and meta‐analysis

Hentschel¹,

Scholte²,

Steens

et al. 2016

Clinical Otolaryngology

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show abstract

“…4,10,60,[96][97][98] Testing with MRI, ABR, or follow-up audiometry is important for detecting vestibular schwannoma because no clinical features can reliably distinguish SSNHL caused by an underlying tumor from the more common idiopathic variety. 4 Tinnitus in the affected ear prior to the onset of the SHL, associated otalgia, or paresthesias are more common in patients with vestibular schwannoma; however, these symptoms are too rare for their absence to reliably rule out a retrocochlear lesion.…”

Section: Risk Of Vestibular Schwannomamentioning

confidence: 99%

“…Although the risk of underlying tumor is lower in patients with low-frequency hearing loss, all types of audiometric patterns have been found in SSNHL patients with vestibular schwannomas. 4,97 Associated events or diseases (eg, barotrauma or recent viral infection) that were presumed to cause the SSNHL are also present in approximately one-third of patients with vestibular schwannoma. Hearing recovery has not been shown to predict whether a patient's SHL is the result of a tumor.…”

Section: Risk Of Vestibular Schwannomamentioning

confidence: 99%

Clinical Practice Guideline

Stachler

Chandrasekhar

Archer

et al. 2012

Otolaryngol.--head neck surg.

786

361

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Objective. Sudden hearing loss (SHL) is a frightening symptom that often prompts an urgent or emergent visit to a physician. This guideline provides evidence-based recommendations for the diagnosis, management, and follow-up of patients who present with SHL. The guideline primarily focuses on sudden sensorineural hearing loss (SSNHL) in adult patients (aged 18 and older). Prompt recognition and management of SSNHL may improve hearing recovery and patient quality of life (QOL). Sudden sensorineural hearing loss affects 5 to 20 per 100,000 population, with about 4000 new cases per year in the United States. This guideline is intended for all clinicians who diagnose or manage adult patients who present with SHL.Purpose. The purpose of this guideline is to provide clinicians with evidence-based recommendations in evaluating patients with SHL, with particular emphasis on managing SSNHL. The panel recognized that patients enter the health care system with SHL as a nonspecific, primary complaint. Therefore, the initial recommendations of the guideline deal with efficiently distinguishing SSNHL from other causes of SHL at the time of presentation. By focusing on opportunities for quality improvement, the guideline should improve diagnostic accuracy, facilitate prompt intervention, decrease variations in management, reduce unnecessary tests and imaging procedures, and improve hearing and rehabilitative outcomes for affected patients.Results. The panel made strong recommendations that clinicians should (1) distinguish sensorineural hearing loss from conductive hearing loss in a patient presenting with SHL; (2) educate patients with idiopathic sudden sensorineural hearing loss (ISSNHL) about the natural history of the condition, the benefits and risks of medical interventions, and the limitations of existing evidence regarding efficacy; and (3) counsel patients with incomplete recovery of hearing about the possible benefits of amplification and hearing-assistive technology and other supportive measures. The panel made recommendations that clinicians should (1) assess patients with presumptive SSNHL for bilateral SHL, recurrent episodes of SHL, or focal neurologic findings; (2) diagnose presumptive ISSNHL if audiometry confirms a 30-dB hearing loss at 3 consecutive frequencies and an underlying condition cannot be identified by history and physical examination; (3) evaluate patients with ISSNHL for retrocochlear pathology by obtaining magnetic resonance imaging, auditory brainstem response, or audiometric follow-up; (4) offer intratympanic steroid perfusion when patients have incomplete recovery from ISSNHL after failure of initial management; and (5) obtain follow-up audiometric evaluation within 6 months of diagnosis for patients with ISSNHL. The panel offered as options that clinicians may offer (1) corticosteroids as initial therapy to patients with ISSNHL and (2) hyperbaric oxygen therapy within 3 months of diagnosis of ISSNHL. The panel made a recommendation against clinicians routinely prescribing antivirals,...

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“…Hearing loss in the course of AN is therefore probably due to a combination of 2 mechanisms: cochlear, as described above, and retrocochlear, i.e., compression of the cochlear nerve by the growing tumor and ischemia caused by pressure of the cochlear blood supply [26]. The atrophy of the cochlear nerve results in a discrepancy between speech discrimination scores and pure tone hearing thresholds, the highest risk of AN in the case of non-improving or progressive hearing loss with basin-shaped audiograms [19]. The consequence of auditory system blast exposure is peripheral and central damage.…”

Section: Ijomeh 2018;31(3)mentioning

confidence: 99%

Increased sensibility to acute acoustic and blast trauma among patients with acoustic neuroma

Mielczarek

Olszewski

2017

Int J Occup Med Environ Health

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The article shows 2 cases of unusual presentation of acute acoustic trauma and blast injury due to occupational exposure. In the case of both patients the range of impaired frequencies in pure tone audiograms was atypical for this kind of causative factor. Both patients had symmetrical hearing before the accident (which was confirmed by provided results of hearing controls during their employment). A history of noise/blast exposure, the onset of symptoms directly after harmful exposure, symmetrical hearing before the trauma documented with audiograms, directed initial diagnosis towards acoustic/blast trauma, however, of atypical course. Acute acoustic and blast trauma and coexisting acoustic neuroma (AN) contributed to, and mutually modified, the course of sudden hearing loss. In the literature there are some reports pointing to a higher sensitivity to acoustic trauma in the case of patients with AN and, on the other hand, indicating noise as one of the causative factors in AN. Int J Occup Med Environ Health 2018;31(3):361 -369

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Prevalence of Acoustic Neuroma Associated with Each Configuration of Pure Tone Audiogram in Patients with Asymmetric Sensorineural Hearing Loss

Abstract: In conclusion, 2.9% to 8.1% of patients with a characteristic configuration of the pure tone audiogram and symptoms of nonimproving or progressive idiopathic sudden deafness may have acoustic neuroma.

Cited by 32 publications

References 13 publications

The diagnostic accuracy of non‐imaging screening protocols for vestibular schwannoma in patients with asymmetrical hearing loss and/or unilateral audiovestibular dysfunction: a diagnostic review and meta‐analysis

The diagnostic accuracy of non‐imaging screening protocols for vestibular schwannoma in patients with asymmetrical hearing loss and/or unilateral audiovestibular dysfunction: a diagnostic review and meta‐analysis

Clinical Practice Guideline

Increased sensibility to acute acoustic and blast trauma among patients with acoustic neuroma

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