Abstract

To the Editor .—We agree with Jerger and Hayes 1 that the latency characteristics of the acoustic reflex are not a helpful indicator of an eighth-nerve tumor. We have found other indicators, eg, reflex decay and abnormalities of the auditory-evoked potential, to be much more relevant in the diagnosis of acoustic neuromas. In our series of patients, with eighth-nerve tumors we also have not noted an increase in latency. We have noted, however, a decrease in the rate of rise of the acoustic reflex in the ear contralateral to an acoustic tumor (only crossed reflexes were used). This decrease in slope would be consistent with a decrease in conductivity in the cochlear nerve on the side of the tumor. We have had a considerable experience (with more than 1,000 patients) with acoustic reflex latency, amplitude, and slope characteristics in a population of patients with vertigo with normal hearing. 2 None

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