[Clinical and therapeutic pitfalls of a bilateral acoustic neurinoma (author's transl)]

A case of bilateral fluctuating deafness accompanied by vertigo and assumed to be Menier's syndrome, a diagnostic hypothesis supported by the effectiveness, on repeated occasions, of medical treatment. In fact, progressive worsening of hearing led to the finding of a bilateral perceptive deafness with a complex vestibular syndrome, whilst tomograms of the petrous temporal bones revealed bilateral acoustic neurinomas. The results of special investigations in this case are analysed: audiometry, Sisi (?) test adaptation, nystagmography, in the light of the radiological findings. It was decided to operate upon the tumour which was larger radiologically. In addition, it revealed multiple neurofibromas of neighboursing nerves (von Recklinghausen's disease). The mid-term course is described. The article ends with a review of clinical concepts in such cases and an attempt to classify therapeutic attitudes to bilateral acoustic neuromas.