Pitfalls in the diagnosis of acoustic and other cerebellopontine angle tumors.

Abstract

AbstractThe early detection of acoustic and other cerebellopontine angle tumors depends upon a high index of suspicion on the part of the otolaryngologist. He must be willing to perform a routine neuro‐otologic evaluation on every patient with unilateral tinnitus, unilateral sensori‐neural hearing loss or any symptoms of an inner ear disorder. The audiometric and vestibular examinations should be reliable and X‐rays of the temporal bone must be of excellent quality.There is a natural tendency to forego X‐rays when a patient seems to have an obivous diagnosis such as Ménière's disease; in fact, there are many such pitfalls in which the physician can allow himself to be misled. The purpose of this paper is to review the neuro‐otologic diagnosis. Six case histories are presented that represent some of the more common pitfalls that can confused the diagnosis of a cerebellopontine angle tumor. The symptoms and objective findings in tumor patients are discussed in detail. Emphasis is placed on the team approach to diagnosis, encouraging cooperation among the otolaryngologist, audiologist, neurosurgeon and radiologist. In this manner, these tumors can be detected when they are small, and their removal can be accomplished with a low morbidity and mortality.