Delayed diagnosis and treatment of acoustic neuroma

The records of 25 patients who underwent excision of acoustic neuroma between 1980 and 1987 were reviewed. All patients originated from southern New England. Facial nerve function was preserved in 92% of all patients, and 42% of patients with tumors less than 2.0 cm retained residual hearing postoperatively. These rates compare favorably with those found in larger series. Our series demonstrated that 60% of patients complained of hearing loss for longer than 2 years prior to tumor diagnosis. The mean duration of hearing loss prior to diagnosis was 4.2 years. Although sophisticated diagnostic methods were generally available, early detection of tumors did not occur, despite the early onset of auditory symptoms. The emergence of sophisticated computer-assisted diagnostic tests and the development of technologically advanced operative methods have reduced operative morbidity, but interestingly, have had little influence on early tumor diagnosis. Late detection of acoustic neuroma in an otherwise medically sophisticated community suggests the need for improved awareness among patients and their primary care providers. Failure of early detection may occur more commonly than generally appreciated, despite the availability of technologically advanced methods of diagnosis.