Acoustic neuroma: Sensitivity and Specificity

Introduction: None written.

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Tags: Neoplasm Otolaryngology Tag this Diagnosis.

Prevalence

Population / Calculator	Prevalence	Comments / Study / Link
Overall	0.02%	This is based on a retrospective analysis of 46,000 MRI done for other reasons, which identified 8 acoustic neuromas. The prevalence of "incidental" acoustic neuroma. Lin D; Hegarty JL; Fischbein NJ; Jackler RK Arch Otolaryngol Head Neck Surg 2005 Mar;131(3):241-4. Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco, USA. PMID 15781765
Neurofibromatosis Type 2	100%	Eventually, close to 100% of NF Type 2 patients will develop bilateral acoustic neuromas. Neurologist. 2006 Mar;12(2):86-93. Neurofibromatosis types 1 and 2. Yohay K. Division of Child Neurology and Pediatrics, Johns Hopkins University, Baltimore, Maryland 21287, USA. kyohay@jhmi.edu PMID: 16534445
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The sensitivity and specificity of findings for Acoustic neuroma are listed below. See the left navigation bar to change the display.

Sensitive Findings

Hearing loss, asymmetric

Sensitivity = 95%

In this study, 5% of patients with an acoustic neuroma had normal or symmetric hearing. Abnormal hearing was defined as an interaural difference of > or =15 dB at a single frequency or > or =10 dB at two or more frequencies, and an interaural speech reception threshold difference of > or =20 dB, or a speech discrimination score of > or =20%

Study: Am J Otol. 1998 Mar;19(2):212-8.

Acoustic neuromas presenting with normal or symmetrical hearing: factors

associated with diagnosis and outcome.

Lustig LR, Rifkin S, Jackler RK, Pitts LH.

Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University,

Baltimore, Maryland, USA.

PMID 9520059

Auditory Brainstem Response test (ABR)

Sensitivity = 85%

Abnormal ABR, measured by CN V latency

This test can be helpful both in diagnosing acoustic neuromas and also in identifying such tumors that are amenable to resection with salvage of hearing

Note: In the following study based on 51 patients with acoustic neuromas the sensitivity was higher for extracranial tumors (24/25 = 96%) than for intracranial tumors (10/15) = 67%

Study: The sensitivity of auditory brainstem response testing in small acoustic neuromas.

Wilson DF; Hodgson RS; Gustafson MF; Hogue S; Mills L

Laryngoscope 1992 Sep;102(9):961-4.

Portland Ear Medical Group, Ore. 97209.

PMID 1518359

Findings With Unspecified Accuracy

Finding	Sensitivity	Specificity	Comments, Study
MRI with Gadolinium Contrast	No accuracy specified.		MRI with gadolinium with milimeter sections through the internal auditory meatus can be used to detect tumors as small as 1 to 2 mm in diameter Study: no study specified.
Vertigo	No accuracy specified.		Study: no study specified.
Cranial Nerve V abnormalities	No accuracy specified.		facial hypoesthesia or paresthesia Study: no study specified.
Cranial Nerve VII abnormalities	No accuracy specified.		Includes: Facial nerve motor weakness as measured by House-Brackman Scale Loss of sensation in posterior superior aspect of external ear canal Study: no study specified.
Headache	No accuracy specified.		Study: no study specified.