Abstract
Two patients with large cerebellopontine (CP) angle tumors and normal pure-tone hearing levels are reported. Case 1, a 49-year-old woman, first experienced hearing distortion in her left ear. Case 2, a 45-year-old woman, first experienced numbness at the tip of her tongue, and then noted hearing loss in the left ear. However, their pure-tone audiograms were normal. In both cases, the Bekesy audiogram showed a type III tracing for the left ear, and the results of auditory brainstem response (ABR) testing were abnormal. A CT scan and a MR imaging demonstrated a CP angle tumor of 6×4 cm size in Case 1, and of 3.5×3 cm size in Case 2. The former was a surgically confirmed CP angle meningioma, and the latter was a surgically suspected facial nerve neuroma. These cases emphasize the fact that a large CP angle tumor can be present without affec-ting pure-tone hearing sensitivity. The clinician must be aware that a subjective hearing impair-ment may be the only clues to the presence of a CP angle tumor. ABR is a valuable procedure for detecting CP angles tumors in patients with normal pure-tone hearing.
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