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Related Experiment Videos

Intermedius nerve involvement and testing in acoustic neuromas.

J Thomsen, K Zilstorff

    Acta Oto-Laryngologica
    |September 1, 1975
    PubMed
    Summary

    Acoustic neuromas diagnosis can be improved by testing the nasolacrimal reflex and tongue taste. These simple tests aid in detecting cerebellopontine angle tumors, especially in patients with unilateral hearing loss.

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    Area of Science:

    • Neurology
    • Otolaryngology
    • Neurosurgery

    Background:

    • Acoustic neuromas, tumors arising from the vestibulocochlear nerve (VIII cranial nerve), often present with hearing loss.
    • Diagnosis can be challenging, particularly for larger tumors affecting adjacent structures like the intermedius nerve.

    Purpose of the Study:

    • To evaluate the diagnostic utility of the nasolacrimal reflex and taste sensation in identifying acoustic neuromas.
    • To highlight the significance of intermedius nerve involvement in cerebellopontine angle pathology.

    Main Methods:

    • Clinical findings from 125 surgically confirmed acoustic neuroma patients were analyzed.
    • Assessment of intermedius nerve function included examination of the nasolacrimal reflex and taste sensation on the anterior two-thirds of the tongue.

    Main Results:

    • Hearing loss was the initial symptom in 85% of patients.
    • A defective nasolacrimal reflex was a significant indicator of cerebellopontine angle pathology, positive in 85% of all cases and 65% of medium-sized tumors.
    • Intermedius nerve tests showed higher positive rates than trigeminal nerve symptoms, contrary to most reports.

    Conclusions:

    • Testing the nasolacrimal reflex and taste sensation are simple, rapid, and valuable diagnostic tools for acoustic neuromas.
    • These tests should be routinely applied to patients with unilateral hearing loss of unknown origin to aid in early detection of cerebellopontine angle pathology.

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