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The sensitivity of auditory brainstem response testing for the diagnosis of acoustic neuromas
R J Schmidt1, R T Sataloff, J Newman
1Department of Otolaryngology-Head and Neck Surgery, Thomas Jefferson University, Philadelphia, Pa, USA.
Objectives:
To determine the sensitivity of auditory brainstem response (ABR) testing for detecting acoustic neuromas and to determine whether the test is less sensitive for detecting small tumors.
Design:
Retrospective review of the medical charts of 58 patients with acoustic neuroma who had all of the data necessary for inclusion in the study.
Setting:
University-affiliated referral practice of one neurotologist.
Patients:
Patients with acoustic neuromas who had both ABR tracings and magnetic resonance imaging films available for review.
Main Outcome Measures:
Positive ABR and negative ABR results correlated with tumor size.
Results:
Tumor size ranged from 0.4 to 7 cm. The overall sensitivity of ABR in diagnosing acoustic neuromas was 90%. However, ABR was progressively less sensitive with decreasing tumor size. Only 7 (58%) of the 12 tumors 1 cm or smaller were detected by ABR.
Conclusion:
Auditory brainstem response testing cannot be relied on for detection of small acoustic neuromas and should not be used as a criterion to determine whether magnetic resonance imaging should be performed when an acoustic neuroma is suspected clinically.
