Acoustic neurinoma with abnormal sensation around the eye but little hearing impairment. A case report and review of the literature.

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An acoustic neurinoma was found in a patient with a chronic floating sensation and abnormal sensation around the left eye but little hearing impairment. A 49-year-old woman had complained for 6 years of a floating sensation and tinnitus on the left. Because her floating sensation gradually worsened she visited our clinic.<BR>Neurotological findings were as follows : persistent right-beating nystagmus in each test of spontaneous nystagmus, positional nystagmus and positioning nystagmus, and the absence of a caloric response on the left. Pure tone audiograms revealed a slight sensori-neural hearing loss with an average of 26 dB. Auditory brainstem responses showed that the I -V interpeak latency interval was prolonged. CT and MRI disclosed a mass in the left cerebellopontine angle. An acoustic neurinoma in the left cerebellopontine angle was removed by neurosurgeons. Specimens from the tumor showed characteristic features of schwannoma (Antoni B type). The postoperative course was almost uneventful, but tinnitus remained on the left.<BR>The literature is reviewed. We emphasize that a longer neurotological follow-up is needed in patients complaining of a floating sensation and tinnitus, even if the hearing impairment is slight, as in this patient. Moreover, ABR is desirable in the diagnostic evaluation of acoustic neurinoma.
一般社団法人日本めまい平衡医学会の論文