Download - Acoustic neuroma inv &man
Good Morning…
A Small presentation by.. S.Vigneshwaran 3rd year Medico
Investigations
&
Management
Investigations• Attempts should be made to
diagnose tumour in its Otological Phase
Intracanalicular
Unilateral sensorineural Hearing loss
TinnitusImbalance
Audiological tests Pure tone Audiometry
Sensorineural hearing loss – High Frequencies
Speech audiometry
Roll over phenomenonReduction of Discrimination score when loudness increased beyond Particular limit
Recruitment phenomenonSmall increase in noise level seems to be much louder and cause discomfort..
SISI
Score 0-20% in 70-90% cases
Threshold tone decay test
• Shows retrocochlear type of lesions
• Cochlear Fatigue
Stapedial reflex decay test
Involuntary muscle contractions
Vestibular tests
Neurological tests
Examination of..
•Cranial nerves
•Cerebellar functions
•Brainstem signs
Fundus Examination
Radiological tests
• Plain X-Rays
Stenver view
Transorbital view
Computed Tomography
Tumour in Posterior fossa
Magnetic Resonance Imaging..
Vertebral AngiographyTo differentiate between Acoustic neuroma & Cerebellopontine angle tumours
Evoked Response Audiometry
• Retrocochlear lesions• 8th Nerve tumour
0.2 msDelay
CSF
Raised Protein Level
Important tests for workup..
• Pure tone audiometry• Speech discrimination score• Roll over curve• Stapedial reflex decay• Evoked response audiometry• MRI with contrast
Treatment
Surgery
Radiotheraphy